Pallidal stimulation as treatment for camptocormia in Parkinson’s disease

Abstract Camptocormia is a common and often debilitating postural deformity in Parkinson’s disease (PD). Few treatments are currently effective. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) shows potential in treating camptocormia, but evidence remains limited to case reports....

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Autores principales:	Yijie Lai, Yunhai Song, Daoqing Su, Linbin Wang, Chencheng Zhang, Bomin Sun, Jorik Nonnekes, Bastiaan R. Bloem, Dianyou Li
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/cd3c72533af544eaab4060b5c97d98cf
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spelling	oai:doaj.org-article:cd3c72533af544eaab4060b5c97d98cf2021-12-02T11:50:41ZPallidal stimulation as treatment for camptocormia in Parkinson’s disease10.1038/s41531-020-00151-w2373-8057https://doaj.org/article/cd3c72533af544eaab4060b5c97d98cf2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41531-020-00151-whttps://doaj.org/toc/2373-8057Abstract Camptocormia is a common and often debilitating postural deformity in Parkinson’s disease (PD). Few treatments are currently effective. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) shows potential in treating camptocormia, but evidence remains limited to case reports. We herein investigate the effect of GPi-DBS for treating camptocormia in a retrospective PD cohort. Thirty-six consecutive PD patients who underwent GPi-DBS were reviewed. The total and upper camptocormia angles (TCC and UCC angles) derived from video recordings of patients who received GPi-DBS were used to compare camptocormia alterations. Correlation analysis was performed to identify factors associated with the postoperative improvements. DBS lead placement and the impact of stimulation were analyzed using Lead-DBS software. Eleven patients manifested pre-surgical camptocormia: seven had lower camptocormia (TCC angles ≥ 30°; TCC-camptocormia), three had upper camptocormia (UCC angles ≥ 45°; UCC-camptocormia), and one had both. Mean follow-up time was 7.3 ± 3.3 months. GPi-DBS improved TCC-camptocormia by 40.4% (angles from 39.1° ± 10.1° to 23.3° ± 8.1°, p = 0.017) and UCC-camptocormia by 22.8% (angles from 50.5° ± 2.6° to 39.0° ± 6.7°, p = 0.012). Improvement in TCC angle was positively associated with pre-surgical TCC angles, levodopa responsiveness of the TCC angle, and structural connectivity from volume of tissue activated to somatosensory cortex. Greater improvement in UCC angles was seen in patients with larger pre-surgical UCC angles. Our study demonstrates potential effectiveness of GPi-DBS for treating camptocormia in PD patients. Future controlled studies with larger numbers of patients with PD-related camptocormia should extend our findings.Yijie LaiYunhai SongDaoqing SuLinbin WangChencheng ZhangBomin SunJorik NonnekesBastiaan R. BloemDianyou LiNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Yijie Lai Yunhai Song Daoqing Su Linbin Wang Chencheng Zhang Bomin Sun Jorik Nonnekes Bastiaan R. Bloem Dianyou Li Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
description	Abstract Camptocormia is a common and often debilitating postural deformity in Parkinson’s disease (PD). Few treatments are currently effective. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) shows potential in treating camptocormia, but evidence remains limited to case reports. We herein investigate the effect of GPi-DBS for treating camptocormia in a retrospective PD cohort. Thirty-six consecutive PD patients who underwent GPi-DBS were reviewed. The total and upper camptocormia angles (TCC and UCC angles) derived from video recordings of patients who received GPi-DBS were used to compare camptocormia alterations. Correlation analysis was performed to identify factors associated with the postoperative improvements. DBS lead placement and the impact of stimulation were analyzed using Lead-DBS software. Eleven patients manifested pre-surgical camptocormia: seven had lower camptocormia (TCC angles ≥ 30°; TCC-camptocormia), three had upper camptocormia (UCC angles ≥ 45°; UCC-camptocormia), and one had both. Mean follow-up time was 7.3 ± 3.3 months. GPi-DBS improved TCC-camptocormia by 40.4% (angles from 39.1° ± 10.1° to 23.3° ± 8.1°, p = 0.017) and UCC-camptocormia by 22.8% (angles from 50.5° ± 2.6° to 39.0° ± 6.7°, p = 0.012). Improvement in TCC angle was positively associated with pre-surgical TCC angles, levodopa responsiveness of the TCC angle, and structural connectivity from volume of tissue activated to somatosensory cortex. Greater improvement in UCC angles was seen in patients with larger pre-surgical UCC angles. Our study demonstrates potential effectiveness of GPi-DBS for treating camptocormia in PD patients. Future controlled studies with larger numbers of patients with PD-related camptocormia should extend our findings.
format	article
author	Yijie Lai Yunhai Song Daoqing Su Linbin Wang Chencheng Zhang Bomin Sun Jorik Nonnekes Bastiaan R. Bloem Dianyou Li
author_facet	Yijie Lai Yunhai Song Daoqing Su Linbin Wang Chencheng Zhang Bomin Sun Jorik Nonnekes Bastiaan R. Bloem Dianyou Li
author_sort	Yijie Lai
title	Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
title_short	Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
title_full	Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
title_fullStr	Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
title_full_unstemmed	Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
title_sort	pallidal stimulation as treatment for camptocormia in parkinson’s disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/cd3c72533af544eaab4060b5c97d98cf
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Pallidal stimulation as treatment for camptocormia in Parkinson’s disease

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