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Anterocollis and Camptocormia in Parkinsonism: A Current Assessment

  • Movement Disorders (SA Factor, Section Editor)
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Abstract

Postural deformities in parkinsonian syndromes are well recognized, but poorly understood and largely refractory to available therapies. In recent times a number of hypotheses have been proposed to explain the underlying etiology of anterocollis and camptocormia, but currently there is no consensus. As these conditions are more precisely characterized we begin to uncover that this is a heterogeneous and evolving phenomenon. These conditions bring to light the inadequacies of our current tools to study biomechanics of posture, neuromuscular disorders, and dystonic muscular contractions. The development of objective, accurate tools to directly study and measure the severity of these postural disorders will allow for further understanding of the pathophysiology, the development of novel therapeutics, and adequate clinical trial design.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Borit A, Rubinstein LJ, Urich H. The striatonigral degenerations. Putaminal pigments and nosology. Brain. 1975;98(1):101–12.

    Article  PubMed  CAS  Google Scholar 

  2. Neumann MA. Pontocerebellar atrophy combined with vestibular-reticular degeneration. J Neuropathol Exp Neurol. 1977;36(2):321–37.

    Article  PubMed  CAS  Google Scholar 

  3. Caplan LR. Clinical features of sporadic (Dejerine-Thomas) olivopontocerebellar atrophy. Adv Neurol. 1984;41:217–24.

    PubMed  CAS  Google Scholar 

  4. Quinn N. Disproportionate antecollis in multiple system atrophy. Lancet. 1989;1(8642):844.

    Article  PubMed  CAS  Google Scholar 

  5. Fujimoto K. Dropped head in Parkinson’s disease. J Neurol. 2006;253 Suppl 7:VII21–26.

    Article  PubMed  Google Scholar 

  6. Ashour R, Jankovic J. Joint and skeletal deformities in Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Mov Disord. 2006;21(11):1856–63.

    Article  PubMed  Google Scholar 

  7. Kashihara K, Ohno M, Tomita S. Dropped head syndrome in Parkinson’s disease. Mov Disord. 2006;21(8):1213–6.

    Article  PubMed  Google Scholar 

  8. Katz JS, Wolfe GI, Burns DK, Bryan WW, Fleckenstein JL, Barohn RJ. Isolated neck extensor myopathy: a common cause of dropped head syndrome. Neurology. 1996;46(4):917–21.

    Article  PubMed  CAS  Google Scholar 

  9. Suarez GA, Kelly Jr JJ. The dropped head syndrome. Neurology. 1992;42(8):1625–7.

    Article  PubMed  CAS  Google Scholar 

  10. Askmark H, Eeg-Olofsson K, Johansson A, Nilsson P, Olsson Y, Aquilonius S. Parkinsonism and neck extensor myopathy: a new syndrome or coincidental findings? Arch Neurol. 2001;58(2):232–7.

    Article  PubMed  CAS  Google Scholar 

  11. Lava NS, Factor SA. Focal myopathy as a cause of anterocollis in Parkinsonism. Mov Disord. 2001;16(4):754–6.

    Article  PubMed  CAS  Google Scholar 

  12. Oyama G, Hayashi A, Mizuno Y, Hattori N. Mechanism and treatment of dropped head syndrome associated with parkinsonism. Parkinsonism Relat Disord. 2008;15(3):181–6.

    Article  PubMed  Google Scholar 

  13. Yoshiyama Y, Takama J, Hattori T. The dropped head sign in parkinsonism. J Neurol Sci. 1999;167(1):22–5.

    Article  PubMed  CAS  Google Scholar 

  14. • Doherty KM, van de Warrenburg BP, Peralta MC, et al. Postural deformities in Parkinson’s disease. Lancet Neurol. 2011;10(6):538–49. This is an excellent comprehensive review on anterocollis and camptocormia.

    Article  PubMed  Google Scholar 

  15. Revuelta GJ, Benatar M, Freeman A, et al. Clinical subtypes of anterocollis in parkinsonian syndromes. J Neurol Sci. 2012;315(1–2):100–3.

    Article  PubMed  Google Scholar 

  16. • Savica R, Kumar N, Ahlskog JE, Josephs KA, Matsumoto JY, McKeon A. Parkinsonism and dropped head: dystonia, myopathy or both? Parkinsonism Relat Disord. 2012;18(1):30–4. This report recognizes distinct clinical subtypes.

    Article  PubMed  Google Scholar 

  17. Djaldetti R, Mosberg-Galili R, Sroka H, Merims D, Melamed E. Camptocormia (bent spine) in patients with Parkinson’s disease—characterization and possible pathogenesis of an unusual phenomenon. Mov Disord. 1999;14(3):443–7.

    Article  PubMed  CAS  Google Scholar 

  18. Gdynia HJ, Sperfeld AD, Unrath A, et al. Histopathological analysis of skeletal muscle in patients with Parkinson’s disease and ‘dropped head’/‘bent spine’ syndrome. Parkinsonism Relat Disord. 2009;15(9):633–9.

    Article  PubMed  Google Scholar 

  19. Margraf NG, Wrede A, Rohr A, et al. Camptocormia in idiopathic Parkinson’s disease: a focal myopathy of the paravertebral muscles. Mov Disord. 2010;25(5):542–51.

    Article  PubMed  Google Scholar 

  20. Spuler S, Krug H, Klein C, et al. Myopathy causing camptocormia in idiopathic Parkinson’s disease: a multidisciplinary approach. Mov Disord. 2010;25(5):552–9.

    Article  PubMed  Google Scholar 

  21. • Ponfick M, Gdynia HJ, Ludolph AC, Kassubek J. Camptocormia in Parkinson’s disease: a review of the literature. Neurodegener Dis. 2011;8(5):283–8. This is a comprehensive review focused on camptocormia.

    Article  PubMed  CAS  Google Scholar 

  22. Aries MJ, Debruyne H, Engelborghs S, et al. Reversal of head drop after discontinuation of olanzapine in a DLB patient. Mov Disord. 2008;23(12):1760–2.

    Article  PubMed  Google Scholar 

  23. Suzuki M, Hirai T, Ito Y, et al. Pramipexole-induced antecollis in Parkinson’s disease. J Neurol Sci. 2008;264(1–2):195–7.

    Article  PubMed  Google Scholar 

  24. Prakash KM, Lang AE. Reversible dopamine agonist induced anterocollis in a multiple system atrophy patient. Mov Disord. 2007;22(15):2292–3.

    Article  PubMed  Google Scholar 

  25. Taguchi Y, Takashima S, Tanaka K. Pramipexole-induced dropped head syndrome in Parkinson’s disease. Intern Med. 2008;47(22):2011–2.

    Article  PubMed  Google Scholar 

  26. van de Warrenburg BP, Cordivari C, Ryan AM, et al. The phenomenon of disproportionate antecollis in Parkinson’s disease and multiple system atrophy. Mov Disord. 2007;22(16):2325–31.

    Article  PubMed  Google Scholar 

  27. Lepoutre AC, Devos D, Blanchard-Dauphin A, et al. A specific clinical pattern of camptocormia in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2006;77(11):1229–34.

    Article  PubMed  Google Scholar 

  28. Azher SN, Jankovic J. Camptocormia: pathogenesis, classification, and response to therapy. Neurology. 2005;65(3):355–9.

    Article  PubMed  Google Scholar 

  29. Lenoir T, Guedj N, Boulu P, Guigui P, Benoist M. Camptocormia: the bent spine syndrome, an update. Eur Spine J. 2010;19(8):1229–37.

    Article  PubMed  Google Scholar 

  30. Jankovic J. Camptocormia, head drop and other bent spine syndromes: heterogeneous etiology and pathogenesis of Parkinsonian deformities. Mov Disord. 2010;25(5):527–8.

    Article  PubMed  Google Scholar 

  31. Broussolle E, Krack P, Thobois S, Xie-Brustolin J, Pollak P, Goetz CG. Contribution of Jules Froment to the study of parkinsonian rigidity. Mov Disord. 2007;22(7):909–14.

    Article  PubMed  Google Scholar 

  32. Carpenter MG, Allum JH, Honegger F, Adkin AL, Bloem BR. Postural abnormalities to multidirectional stance perturbations in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2004;75(9):1245–54.

    Article  PubMed  CAS  Google Scholar 

  33. Finsterer J, Strobl W. Presentation, etiology, diagnosis, and management of camptocormia. Eur Neurol. 2010;64(1):1–8.

    Article  PubMed  Google Scholar 

  34. Gerton BK, Theeler B, Samii A. Backpack treatment for camptocormia. Mov Disord. 2010;25(2):247–8.

    Article  PubMed  Google Scholar 

  35. Fast A, Thomas MA. The “baseball cap orthosis”: a simple solution for dropped head syndrome. Am J Phys Med Rehab. 2008;87(1):71–3.

    Article  Google Scholar 

  36. Glass GA, Ku S, Ostrem JL, Heath S, Larson PS. Fluoroscopic, EMG-guided injection of botulinum toxin into the longus colli for the treatment of anterocollis. Parkinsonism Relat Disord. 2009;15(8):610–3.

    Article  PubMed  Google Scholar 

  37. Herting B, Wunderlich S, Glockler T, et al. Computed tomographically-controlled injection of botulinum toxin into the longus colli muscle in severe anterocollis. Mov Disord. 2004;19(5):588–90.

    Article  PubMed  Google Scholar 

  38. Lee IH, Yoon YC, Sung DH, Kwon JW, Jung JY. Initial experience with imaging-guided intramuscular botulinum toxin injection in patients with idiopathic cervical dystonia. AJR Am J Roentgenol. 2009;192(4):996–1001.

    Article  PubMed  Google Scholar 

  39. Sung DH, Choi JY, Kim DH, et al. Localization of dystonic muscles with 18F-FDG PET/CT in idiopathic cervical dystonia. J Nucl Med. 2007;48(11):1790–5.

    Article  PubMed  Google Scholar 

  40. Flowers JM, Hicklin LA, Marion MH. Anterior and posterior sagittal shift in cervical dystonia: a clinical and electromyographic study, including a new EMG approach of the longus colli muscle. Mov Disord. 2011;26(13):2409–14.

    Article  PubMed  Google Scholar 

  41. Revuelta GJ, Factor SA. Clinical subtypes of Disproportionate Anterocollis in Parkinsonian syndromes. Neurology. 2010;47(supplement 2):A88.

    Google Scholar 

  42. Kastrup A, Gdynia HJ, Nagele T, Riecker A. Dropped-head syndrome due to steroid responsive focal myositis: a case report and review of the literature. J Neurol Sci. 2008;267(1–2):162–5.

    Article  PubMed  Google Scholar 

  43. Yamada K, Goto S, Matsuzaki K, et al. Alleviation of camptocormia by bilateral subthalamic nucleus stimulation in a patient with Parkinson’s disease. Parkinsonism Relat Disord. 2006;12(6):372–5.

    Article  PubMed  Google Scholar 

  44. Petheram TG, Hourigan PG, Emran IM, Weatherley CR. Dropped head syndrome: a case series and literature review. Spine (Phila Pa 1976). 2008;33(1):47–51.

    Article  Google Scholar 

Download references

Disclosure

Conflicts of interest: G.J. Revuelta: has received grant support from Biotie, Phytopharm, and NIH; and has received payment for lectures including service on speakers’ bureaus from Teva and Lundbeck.

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Correspondence to Gonzalo J. Revuelta.

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Revuelta, G.J. Anterocollis and Camptocormia in Parkinsonism: A Current Assessment. Curr Neurol Neurosci Rep 12, 386–391 (2012). https://doi.org/10.1007/s11910-012-0280-9

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