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Hong R, Zhang T, Zhang Z, Wu Z, Lin A, Su X, Jin Y, Gao Y, Peng K, Li L, Pan L, Zhi H, Guan Q, Jin L. A summary index derived from Kinect to evaluate postural abnormalities severity in Parkinson’s Disease patients. NPJ Parkinsons Dis 2022; 8:96. [PMID: 35918362 PMCID: PMC9345864 DOI: 10.1038/s41531-022-00368-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractPostural abnormalities are common disabling motor complications affecting patients with Parkinson’s disease (PD). We proposed a summary index for postural abnormalities (IPA) based on Kinect depth camera and explored the clinical value of this indicator. Seventy individuals with PD and thirty age-matched healthy controls (HCs) were enrolled. All participants were tested using a Kinect-based system with IPA automatically obtained by algorithms. Significant correlations were detected between IPA and the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) total score (rs = 0.369, p = 0.002), MDS-UPDRS-III total score (rs = 0.431, p < 0.001), MDS-UPDRS-III 3.13 score (rs = 0.573, p < 0.001), MDS-UPDRS-III-bradykinesia score (rs = 0.311, p = 0.010), the 39-item Parkinson’s Disease Questionnaire (PDQ-39) (rs = 0.272, p = 0.0027) and the Berg Balance Scale (BBS) score (rs = −0.350, p = 0.006). The optimal cut-off value of IPA for distinguishing PD from HCs was 12.96 with a sensitivity of 97.14%, specificity of 100.00%, area under the curve (AUC) of 0.999 (0.997–1.002, p < 0.001), and adjusted AUC of 0.998 (0.993–1.000, p < 0.001). The optimal cut-off value of IPA for distinguishing between PD with and without postural abnormalities was 20.14 with a sensitivity, specificity, AUC and adjusted AUC of 77.78%, 73.53%, 0.817 (0.720–0.914, p < 0.001), and 0.783 (0.631–0.900, p < 0.001), respectively. IPA was significantly correlated to the clinical manifestations of PD patients, and could reflect the global severity of postural abnormalities in PD with important value in distinguishing PD from HCs and distinguishing PD with postural abnormalities from those without.
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Tinazzi M, Gandolfi M, Ceravolo R, Capecci M, Andrenelli E, Ceravolo MG, Bonanni L, Onofrj M, Vitale M, Catalan M, Polverino P, Bertolotti C, Mazzucchi S, Giannoni S, Smania N, Tamburin S, Vacca L, Stocchi F, Radicati FG, Artusi CA, Zibetti M, Lopiano L, Fasano A, Geroin C. Postural Abnormalities in Parkinson's Disease: An Epidemiological and Clinical Multicenter Study. Mov Disord Clin Pract 2019; 6:576-585. [PMID: 31538092 PMCID: PMC6749805 DOI: 10.1002/mdc3.12810] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/01/2019] [Accepted: 06/12/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The overall frequency of postural abnormalities (PA) in Parkinson's disease (PD) is unknown. We evaluated the overall prevalence of PA and assessed the association with demographic and clinical variables. METHODS For this multicenter, cross-sectional study, consecutive PD outpatients attending 7 tertiary Italian centers were enrolled. Patients were evaluated and compared for the presence of isolated PA such as camptocormia, Pisa syndrome, and anterocollis and for combined forms (ie, camptocormia + Pisa syndrome) together with demographic and clinical variables. RESULTS Of the total 811 PD patients enrolled, 174 (21.5%; 95% confidence interval [CI], 18.6%-24.3%) presented PA, 144 of which had isolated PA and 30 had combined PA. The prevalence of camptocormia was 11.2% (95% CI, 9%-13.3%), Pisa syndrome 8% (95% CI, 6.2%-9.9%), and anterocollis 6.5% (95% CI, 4.9%-8.3%). Patients with PA were more often male and older with longer disease duration, more advanced disease stage, more severe PD symptoms, a bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with levodopa, and more likely to be treated with a combination of levodopa and dopamine agonist, took a higher daily levodopa equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD patients with PA than in those without PA. Multiple logistic regression models confirmed an association between PA and male gender, older age, Hoehn and Yahr stage, and total Unified Parkinson's Disease Rating Scale score. CONCLUSIONS PA are frequent and disabling complications in PD, especially in the advanced disease stages.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
- Neurorehabilitation UnitAzienda Ospedaliera Universitaria IntegrataVeronaItaly
| | - Roberto Ceravolo
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Marianna Capecci
- Department of Experimental and Clinical MedicineNeurorehabilitation Clinic, “Politecnica delle Marche” UniversityAnconaItaly
| | - Elisa Andrenelli
- Department of Experimental and Clinical MedicineNeurorehabilitation Clinic, “Politecnica delle Marche” UniversityAnconaItaly
| | - Maria Gabriella Ceravolo
- Department of Experimental and Clinical MedicineNeurorehabilitation Clinic, “Politecnica delle Marche” UniversityAnconaItaly
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical SciencesUniversity G. d'Annunzio of Chieti‐PescaraChieti‐PescaraItaly
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical SciencesUniversity G. d'Annunzio of Chieti‐PescaraChieti‐PescaraItaly
| | - Michela Vitale
- Department of Neuroscience, Imaging and Clinical SciencesUniversity G. d'Annunzio of Chieti‐PescaraChieti‐PescaraItaly
| | - Mauro Catalan
- Clinical Neurology Unit, Department of Medical, Surgical and Health ServicesUniversity of TriesteTriesteItaly
| | - Paola Polverino
- Clinical Neurology Unit, Department of Medical, Surgical and Health ServicesUniversity of TriesteTriesteItaly
| | - Claudio Bertolotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health ServicesUniversity of TriesteTriesteItaly
| | - Sonia Mazzucchi
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Sara Giannoni
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
- Neurorehabilitation UnitAzienda Ospedaliera Universitaria IntegrataVeronaItaly
| | - Stefano Tamburin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Laura Vacca
- University and Institute for Research and Medical Care, Istituto di Ricovero e Cura a Carattere ScientificoSan RaffaeleRomaItaly
| | - Fabrizio Stocchi
- University and Institute for Research and Medical Care, Istituto di Ricovero e Cura a Carattere ScientificoSan RaffaeleRomaItaly
| | - Fabiana G. Radicati
- University and Institute for Research and Medical Care, Istituto di Ricovero e Cura a Carattere ScientificoSan RaffaeleRomaItaly
| | - Carlo Alberto Artusi
- Department of Neuroscience “Rita Levi Montalcini,”University of TorinoTorinoItaly
| | - Maurizio Zibetti
- Department of Neuroscience “Rita Levi Montalcini,”University of TorinoTorinoItaly
| | - Leonardo Lopiano
- Department of Neuroscience “Rita Levi Montalcini,”University of TorinoTorinoItaly
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western HospitalUniversity Health Network, Division of Neurology, University of TorontoTorontoOntarioCanada
- Krembil Brain InstituteTorontoOntarioCanada
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
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Tinazzi M, Geroin C, Gandolfi M, Smania N, Tamburin S, Morgante F, Fasano A. Pisa syndrome in Parkinson's disease: An integrated approach from pathophysiology to management. Mov Disord 2016; 31:1785-1795. [PMID: 27779784 DOI: 10.1002/mds.26829] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/09/2016] [Accepted: 09/11/2016] [Indexed: 12/26/2022] Open
Abstract
Pisa syndrome was first described in 1972 in patients treated with neuroleptics. Since 2003, when it was first reported in patients with Parkinson's disease (PD), Pisa syndrome has progressively drawn the attention of clinicians and researchers. Although emerging evidence has partially clarified its prevalence and pathophysiology, the current debate revolves around diagnostic criteria and assessment and the effectiveness of pharmacological, surgical, and rehabilitative approaches. Contrary to initial thought, Pisa syndrome is common among PD patients, with an estimated prevalence of 8.8% according to a large survey. Furthermore, it is associated with the following specific patient features: more severe motor phenotype, ongoing combined pharmacological treatment with levodopa and dopamine agonists, gait disorders, and such comorbidities as osteoporosis and arthrosis. The present literature on treatment outcomes is scant, and the uneven effectiveness of specific treatments has produced conflicting results. This might be because of the limited knowledge of Pisa syndrome pathophysiology and its variable clinical presentation, which further complicates designing randomized clinical trials on this condition. However, because some forms of Pisa syndrome are potentially reversible, there is growing consensus on the importance of its early recognition and the importance of pharmacological adjustment and rehabilitation. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Geroin
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
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