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      • Record: found
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      Effect of istradefylline on postural abnormalities in patients with Parkinson's disease: An association study of baseline postural angle measurements with changes in Unified Dystonia Rating Scale total score

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          Abstract

          In our previous study, istradefylline treatment in patients with Parkinson's disease (PD) improved postural abnormalities (PAs), as seen from a decrease in the mean Unified Dystonia Rating Scale (UDRS) total score from week 0 to week 24. A subgroup analysis based on baseline clinical characteristics investigated the association between improvement in the UDRS total score and istradefylline treatment. However, the association between an objective assessment of PAs and improvement in the UDRS total score is unclear. This ad hoc analysis investigated the association between improvement in the UDRS total score after istradefylline treatment and baseline trunk and neck angles, objective assessments of PAs, measured from patients' photographs taken in the previous study. The patients ( n = 31) were stratified into groups based on the trunk forward flexion angle (TFFA), trunk lateral flexion angle (TLFA), and neck flexion angle (NFA) values at baseline. From week 0 to week 24, significant improvements in the UDRS total score were found in median percent change (−8.33% [interquartile range: −43.97, 0.00], P = 0.039) in patients with equal to or above the median TFFA values, and in median change (−‍1.50 [−9.25, 0.00], P = 0.015) and median percent change (−13.33% [−50.47, 0.00], P = 0.009) in patients with equal to or above the median TLFA values. Patients with more advanced PAs showed more consistent improvements in the UDRS total score with istradefylline. Baseline TFFA and TLFA values, which are objective values, may be useful to assess the istradefylline effectiveness in patients with PD and PAs.

          Highlights

          • •

            Analysis of istradefylline in Parkinson's disease with postural abnormalities (PAs).

          • •

            Earlier, istradefylline improved Unified Dystonia Rating Scale (UDRS) total score.

          • •

            Association between baseline trunk and neck angles and changes in UDRS total score.

          • •

            Subgroups based on below and equal to or above median trunk and neck angle values.

          • •

            More advanced PAs showed more consistent improvements with istradefylline in UDRS.

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          Most cited references9

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          Parkinson's disease with camptocormia.

          F Bloch, F Bonneville, F Etchepare … (2006)
          Camptocormia is defined as an abnormal flexion of the trunk that appears when standing or walking and disappears in the supine position. The origin of the disorder is unknown, but it is usually attributed either to a primary or a secondary paravertebral muscle myopathy or a motor neurone disorder. Camptocormia is also observed in a minority of patients with parkinsonism. To characterise the clinical and electrophysiological features of camptocormia and parkinsonian symptoms in patients with Parkinson's disease and camptocormia compared with patients with Parkinson's disease without camptocormia. Patients with parkinsonism and camptocormia (excluding patients with multiple system atrophy) prospectively underwent a multidisciplinary clinical (neurological, neuropsychological, psychological, rheumatological) and neurophysiological (electromyogram, ocular movement recording) examination and were compared with age-matched patients with Parkinson's disease without camptocormia. The camptocormia developed after 8.5 (SD 5.3) years of parkinsonism, responded poorly to levodopa treatment (20%) and displayed features consistent with axial dystonia. Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm. We suggest that (1) the salient features of parkinsonism observed in patients with camptocormia are likely to represent a specific form of Parkinson's disease and camptocormia is an axial dystonia and (2) both camptocormia and parkinsonism in these patients might result from additional, non-dopaminergic neuronal dysfunction in the basal ganglia.
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            Clinical correlates of anterior and lateral flexion of the thoracolumbar spine and dropped head in patients with Parkinson's disease.

            Kenichi Kashihara, Takaki Imamura (2012)
            Parkinson's disease (PD) is often accompanied by postural disorders such as anterior and lateral flexion of the thoracolumbar spine and dropped head. We examined frequencies and clinical correlates of postural disorders in patients with PD. We interviewed 365 consecutive PD patients between 40 and 80 years of age, at Hoehn and Yahr stages 1, 2, 3 and 4, and evaluated postural deformities, including anterior and lateral flexion of the trunk and dropped head as well as other clinical characteristics. Control subjects were 65 age-matched patient spouses without neurological or spinal disorders. There were no differences in age or sex between PD patients and controls. The frequencies of anterior and lateral flexion of the trunk were significantly higher in PD patients than in controls. The frequency and severity of anterior and lateral flexion and the incidence of dropped head increased as the disease progressed. Other factors related to anterior and lateral flexion included age, disease duration, lower MMSE score, lumbago and levodopa equivalent daily dose of dopaminergic drugs. Women tended to develop more severe anterior flexion than men. Anterior flexion severity also correlated with that of lateral flexion and the emergence of dropped head. Postural disorders are frequent complications in PD patients and their severity increases with disease progression. Advancing age and disease severity may be the major risks for developing postural disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Long-term effect of repeated lidocaine injections into the external oblique for upper camptocormia in Parkinson's disease

              Yoshihiko Furusawa, Yohei Mukai, Tomoya Kawazoe … (2013)
              Parkinson's disease (PD) is occasionally complicated by camptocormia. In a previous study, we classified camptocormia into upper and lower types based on the inflection point, and reported that lidocaine injection into the external oblique muscle, but not into the internal oblique or rectus abdomen, improved upper camptocormia in PD. The effect of a single lidocaine injection disappeared over a period of few days. In this study, we used repeated lidocaine injections into the external oblique for 4-5 days and evaluated the effects of such treatment for up to 90 days.
              Article 0 comments Cited 13 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Makio Takahashi
                Journal
                Journal ID (nlm-ta): eNeurologicalSci
                Journal ID (iso-abbrev): eNeurologicalSci
                Title: eNeurologicalSci
                Publisher: Elsevier
                ISSN (Electronic): 2405-6502
                Publication date PMC-release: 30 December 2023
                Publication date Collection: March 2024
                Publication date (Electronic): 30 December 2023
                Volume: 34
                Electronic Location Identifier: 100493
                Affiliations
                [a ]Department of Neurology, Kitano Hospital, The Tazuke-Kofukai Medical Research Institute, Osaka, Japan
                [b ]Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan
                [c ]Department of Neurology, Wakayama Medical University, Wakayama, Japan
                [d ]Department of Neurology, Tominaga Hospital, Osaka, Japan
                [e ]Department of Neurology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
                [f ]Department of Neurology, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
                Author notes
                [* ]Corresponding author at: Department of Neurology, Kitano Hospital, The Tazuke-Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-Ku, Osaka 530-0025, Japan. ta@ 123456kuhp.kyoto-u.ac.jp
                Article
                Publisher Item ID: S2405-6502(23)00051-5 Publisher ID: 100493
                DOI: 10.1016/j.ensci.2023.100493
                PMC ID: 10809095
                PubMed ID: 38274039
                SO-VID: 76687583-0c2c-4f23-9e2c-7b2857cabb2d
                Copyright © © 2024 The Authors. Published by Elsevier B.V.
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 13 April 2023
                Date revision received : 16 October 2023
                Date accepted : 27 December 2023
                Categories
                Subject: Original Article

                Keywords: angle value,istradefylline,parkinson's disease,postural abnormalities,unified dystonia rating scale
                Data availability:
                Keywords: angle value, istradefylline, parkinson's disease, postural abnormalities, unified dystonia rating scale

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