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Review
. 2016 Jan;87(1):75-85.
doi: 10.1136/jnnp-2014-310049. Epub 2015 Apr 20.

Camptocormia in Parkinson's disease: definition, epidemiology, pathogenesis and treatment modalities

Prachaya Srivanitchapoom  1 , Mark Hallett  2
Affiliations
Review

Camptocormia in Parkinson's disease: definition, epidemiology, pathogenesis and treatment modalities

Prachaya Srivanitchapoom et al. J Neurol Neurosurg Psychiatry. 2016 Jan.

Abstract

Camptocormia is an axial postural deformity characterised by abnormal thoracolumbar spinal flexion. The symptom usually presents while standing, walking or exercising and is alleviated while sitting, lying in a recumbent position, standing against a wall or using walking support. There is no consensus on the degree of thoracolumbar flexion to define camptocormia. However, most authors usually use an arbitrary number of at least 45° flexion of the thoracolumbar spine when the individual is standing or walking. Aetiologies of camptocormia are heterogeneous, and Parkinson's disease (PD) is one of its many causes. The prevalence of camptocormia in PD ranges from 3% to 18%. Central and peripheral mechanisms might both contribute to its pathogenesis. Although there is no established consensus for treatment of camptocormia in PD, there are non-pharmacological, pharmacological and surgical approaches that can be used.

Keywords: CLINICAL NEUROLOGY; MOVEMENT DISORDERS; PARKINSON'S DISEASE.

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Conflict of interest statement

Competing interests MH serves as Chair of the Medical Advisory Board for and receives honoraria and funding for travel from the Neurotoxin Institute. He may accrue revenue on US Patent #6 780 413 B2 (Issued: 24 August 2004): Immunotoxin (MAB-Ricin) for the treatment of focal movement disorders, and US Patent #7 407 478 (Issued: 5 August 2008): Coil for Magnetic Stimulation and methods for using the same (H-coil); in relation to the latter, he has received licence fee payments from the NIH (from Brainsway) for licencing of this patent. He is on the Editorial Board of 20 journals, and has received royalties from publishing from Cambridge University Press, Oxford University Press, John Wiley & Sons, Wolters Kluwer and Elsevier. He has received honoraria for lecturing from Columbia University and the Parkinson and Aging Research Foundation. MH’s research at the NIH is largely supported by the NIH Intramural Programme. Supplemental research funds came from the Kinetics Foundation, for studies of instrumental methods to monitor Parkinson’s disease, and BCN Peptides, SA, for treatment studies of blepharospasm.

Figures

Figure 1
Figure 1
Patients with Parkinson’s disease presenting with truncal flexion greater than 45° while standing. (A) Upper camptocormia defined as abnormal truncal flexion at a point between the lower thoracic and upper lumbar spine. (B) Lower camptocormia defined as flexion at the hip joint.
See this image and copyright information in PMC

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