Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review

Carlo Alberto Artusi; Christian Geroin; Jorik Nonnekes; Camila Aquino; Divyani Garg; Marian L. Dale; Darbe Schlosser; Yijie Lai; Mohammad Al‐Wardat; Mehri Salari; Robin Wolke; Valery Tsinda Labou; Gabriele Imbalzano; Serena Camozzi; Marcelo Merello; Bastiaan R. Bloem; Tamine Capato; Ruth Djaldetti; Karen Doherty; Alfonso Fasano; Houyam Tibar; Leonardo Lopiano; Nils G. Margraf; Caroline Moreau; Yoshikazu Ugawa; Roongroj Bhidayasiri; Michele Tinazzi

doi:10.1002/mdc3.13879

Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review

Carlo Alberto Artusi, Christian Geroin^*, Jorik Nonnekes, Camila Aquino, Divyani Garg, Marian L. Dale, Darbe Schlosser, Yijie Lai, Mohammad Al‐Wardat, Mehri Salari, Robin Wolke, Valery Tsinda Labou, Gabriele Imbalzano, Serena Camozzi, Marcelo Merello, Bastiaan R. Bloem, Tamine Capato, Ruth Djaldetti, Karen Doherty, Alfonso FasanoHouyam Tibar, Leonardo Lopiano, Nils G. Margraf, Caroline Moreau, Yoshikazu Ugawa, Roongroj Bhidayasiri, Michele Tinazzi^*

^*Corresponding author for this work

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

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Abstract

Background
Postural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies.

Objectives
We conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic.

Methods
We applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.

Results
Ninety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms.

Conclusions
The recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.

Original language	English
Pages (from-to)	1585-1596
Number of pages	12
Journal	Movement Disorders Clinical Practice
Volume	10
Issue number	11
Early online date	25 Sept 2023
DOIs	https://doi.org/10.1002/mdc3.13879
Publication status	Published - 17 Nov 2023

Keywords

Antecollis
Camptocormia
Parkinsonisms
Pisa syndrome
axial postural abnormalities
clinical predictors
pathophysiology

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10.1002/mdc3.13879Licence: CC BY-NC-ND

Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review
Copyright 2023 The Authors. This is an open access article published under a Creative Commons Attribution-NonCommercial-NoDerivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 677 KBLicence: CC BY-NC-ND

Cite this

Artusi, C. A., Geroin, C., Nonnekes, J., Aquino, C., Garg, D., Dale, M. L., Schlosser, D., Lai, Y., Al‐Wardat, M., Salari, M., Wolke, R., Labou, V. T., Imbalzano, G., Camozzi, S., Merello, M., Bloem, B. R., Capato, T., Djaldetti, R., Doherty, K., ... Tinazzi, M. (2023). Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review. Movement Disorders Clinical Practice, 10(11), 1585-1596. https://doi.org/10.1002/mdc3.13879

@article{39d101b8ff9b4fbd8d138ca7ed7ceb5f,

title = "Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review",

abstract = "BackgroundPostural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies.ObjectivesWe conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic.MethodsWe applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.ResultsNinety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms.ConclusionsThe recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.",

keywords = "Antecollis, Camptocormia, Parkinsonisms, Pisa syndrome, axial postural abnormalities, clinical predictors, pathophysiology",

author = "Artusi, {Carlo Alberto} and Christian Geroin and Jorik Nonnekes and Camila Aquino and Divyani Garg and Dale, {Marian L.} and Darbe Schlosser and Yijie Lai and Mohammad Al‐Wardat and Mehri Salari and Robin Wolke and Labou, {Valery Tsinda} and Gabriele Imbalzano and Serena Camozzi and Marcelo Merello and Bloem, {Bastiaan R.} and Tamine Capato and Ruth Djaldetti and Karen Doherty and Alfonso Fasano and Houyam Tibar and Leonardo Lopiano and Margraf, {Nils G.} and Caroline Moreau and Yoshikazu Ugawa and Roongroj Bhidayasiri and Michele Tinazzi",

year = "2023",

month = nov,

day = "17",

doi = "10.1002/mdc3.13879",

language = "English",

volume = "10",

pages = "1585--1596",

journal = "Movement Disorders Clinical Practice",

issn = "2330-1619",

publisher = "John Wiley & Sons Ltd",

number = "11",

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Artusi, CA, Geroin, C, Nonnekes, J, Aquino, C, Garg, D, Dale, ML, Schlosser, D, Lai, Y, Al‐Wardat, M, Salari, M, Wolke, R, Labou, VT, Imbalzano, G, Camozzi, S, Merello, M, Bloem, BR, Capato, T, Djaldetti, R, Doherty, K, Fasano, A, Tibar, H, Lopiano, L, Margraf, NG, Moreau, C, Ugawa, Y, Bhidayasiri, R & Tinazzi, M 2023, 'Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review', Movement Disorders Clinical Practice, vol. 10, no. 11, pp. 1585-1596. https://doi.org/10.1002/mdc3.13879

TY - JOUR

T1 - Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review

AU - Artusi, Carlo Alberto

AU - Geroin, Christian

AU - Nonnekes, Jorik

AU - Aquino, Camila

AU - Garg, Divyani

AU - Dale, Marian L.

AU - Schlosser, Darbe

AU - Lai, Yijie

AU - Al‐Wardat, Mohammad

AU - Salari, Mehri

AU - Wolke, Robin

AU - Labou, Valery Tsinda

AU - Imbalzano, Gabriele

AU - Camozzi, Serena

AU - Merello, Marcelo

AU - Bloem, Bastiaan R.

AU - Capato, Tamine

AU - Djaldetti, Ruth

AU - Doherty, Karen

AU - Fasano, Alfonso

AU - Tibar, Houyam

AU - Lopiano, Leonardo

AU - Margraf, Nils G.

AU - Moreau, Caroline

AU - Ugawa, Yoshikazu

AU - Bhidayasiri, Roongroj

AU - Tinazzi, Michele

PY - 2023/11/17

Y1 - 2023/11/17

N2 - BackgroundPostural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies.ObjectivesWe conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic.MethodsWe applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.ResultsNinety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms.ConclusionsThe recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.

AB - BackgroundPostural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies.ObjectivesWe conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic.MethodsWe applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.ResultsNinety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms.ConclusionsThe recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.

KW - Antecollis

KW - Camptocormia

KW - Parkinsonisms

KW - Pisa syndrome

KW - axial postural abnormalities

KW - clinical predictors

KW - pathophysiology

U2 - 10.1002/mdc3.13879

DO - 10.1002/mdc3.13879

M3 - Article

SN - 2330-1619

VL - 10

SP - 1585

EP - 1596

JO - Movement Disorders Clinical Practice

JF - Movement Disorders Clinical Practice

IS - 11

ER -

Predictors and pathophysiology of axial postural abnormalities in Parkinsonism: a scoping review

Abstract

Keywords

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