Pisa syndrome in Parkinson’s disease: an electrophysiological and imaging study

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• 作者：Michele Tinazzi (1)
  Ina Juergenson (1)
  Giovanna Squintani (1)
  Gaetano Vattemi (1)
  Stefania Montemezzi (2)
  Daniela Censi (2)
  Paolo Barone (3)
  Tommaso Bovi (1)
  Alfonso Fasano (4)
  
• 关键词：Electromyography ; Dystonia ; Pathophysiology ; Parkinson’s disease ; Pisa syndrome ; Magnetic resonance imaging
• 刊名：Journal of Neurology
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：260
• 期：8
• 页码：2138-2148
• 全文大小：653KB
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• 作者单位：Michele Tinazzi (1)
  Ina Juergenson (1)
  Giovanna Squintani (1)
  Gaetano Vattemi (1)
  Stefania Montemezzi (2)
  Daniela Censi (2)
  Paolo Barone (3)
  Tommaso Bovi (1)
  Alfonso Fasano (4)
  
  1. Dipartimento di Scienze Neurologiche, Psicologiche, Morfologiche e Motorie, Università di Verona, Verona, Italy
  2. Istituto di Radiologia, Azienda Ospedaliera-Universitaria Integrata di Verona, Verona, Italy
  3. Dipartimento di Neuroscienze, Università di Salerno, Salerno, Italy
  4. Division of Neurology, Movement Disorders Center, TWH, UHN, University of Toronto, 399 Bathurst St, 7 MC412, Toronto, ON, M5T 2S8, Canada
  

文摘

The pathophysiology of postural abnormalities in patients with Parkinson’s disease is poorly understood. In the present study, 13 patients with Pisa syndrome (PS) underwent EMG study of paraspinal lumbar (L2–L4) and thoracic (T8–T10) muscles, and of non-paraspinal muscles. Patients also underwent a whole spine X-ray and an MRI assessment of paraspinal muscles (L1–S1). The EMG evaluation disclosed two main patterns: patients with pattern I (n?=?6, hyperactivity of lumbar paraspinals ipsilateral to the trunk leaning side) or pattern II (n?=?7: hyperactivity of lumbar paraspinals contralateral to the trunk leaning side. In pattern I, half the patients also had ipsilateral hyperactivity of the thoracic paraspinals, the other half had contralateral thoracic hyperactivity; in pattern II, thoracic paraspinal hyperactivity was contralateral in all patients (like the lumbar paraspinal hyperactivity). Non-paraspinal muscles were hyperactive ipsilaterally in four of six patients with pattern I and in all patients with pattern II. The MRI showed mild muscular atrophy with fatty degeneration in patients with pattern I, whereas in pattern II patients this was greater and prevalent on paraspinal lumbar muscles ipsilateral to the leaning side. The present data support the hypothesis that two main patterns of muscular activation are associated with PS. In both patterns, hyperactivity of contralateral paraspinal muscles is probably compensatory for the trunk leaning.