Pallidal stimulation as treatment for camptocormia in Parkinson’s disease
Open Access
- 18 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in npj Parkinson's Disease
- Vol. 7 (1), 1-7
- https://doi.org/10.1038/s41531-020-00151-w
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.This publication has 39 references indexed in Scilit:
- Turning tablesNeurology, 2012
- High-Frequency Pallidal Stimulation for Camptocormia in Parkinson Disease: Case ReportNeurosurgery, 2011
- Restoration of erect posture in idiopathic camptocormia by electrical stimulation of the globus pallidus internusJournal of Neurosurgery, 2010
- Levodopa and subthalamic deep brain stimulation responses are not congruentMovement Disorders, 2010
- Effect of subthalamic deep brain stimulation on postural abnormality in Parkinson diseaseJournal of Neurosurgery, 2010
- Spondylolisthesis following a pedicle subtraction osteotomyNeurosurgical Focus, 2010
- Spinal deformity and Parkinson disease: a treatment algorithmNeurosurgical Focus, 2010
- Dopamine agonist‐induced antecollis in Parkinson's diseaseMovement Disorders, 2009
- Three-dimensional locations and boundaries of motor and premotor cortices as defined by functional brain imaging: A meta-analysisNeuroImage, 2006
- Preoperative Clinical Predictors of Response to Bilateral Subthalamic Stimulation in Patients with Parkinson’s DiseaseStereotactic and Functional Neurosurgery, 2005