Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review.

Bibliographic Details
Title: Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review.
Authors: Artusi, Carlo Alberto, Geroin, Christian, Nonnekes, Jorik, Aquino, Camila, Garg, Divyani, Dale, Marian L., Schlosser, Darbe, Lai, Yijie, Al‐Wardat, Mohammad, Salari, Mehri, Wolke, Robin, Labou, Valery Tsinda, Imbalzano, Gabriele, Camozzi, Serena, Merello, Marcelo, Bloem, Bastiaan R., Capato, Tamine, Djaldetti, Ruth, Doherty, Karen, Fasano, Alfonso
Source: Movement Disorders Clinical Practice; Nov2023, Vol. 10 Issue 11, p1585-1596, 12p
Subject Terms: PARKINSONIAN disorders, PATHOLOGICAL physiology, PARKINSON'S disease, MULTIPLE system atrophy, HUMAN abnormalities, MOVEMENT disorders
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. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:23301619
DOI:10.1002/mdc3.13879
Published in:Movement Disorders Clinical Practice
Language:English