Pisa syndrome in Parkinson disease

Michele Tinazzi, Alfonso Fasano, Christian Geroin, Francesca Morgante, Roberto Ceravolo, Simone Rossi, Astrid Thomas, Giovanni Fabbrini, Annarita Bentivoglio, Filippo Tamma, Giovanni Cossu, Nicola Modugno, Mario Zappia, Maria Antonietta Volontè, Carlo Dallocchio, Giovanni Abbruzzese, Claudio Pacchetti, Roberto Marconi, Giovanni Defazio, Margherita CanesiAntonino Cannas, Antonio Pisani, Rina Mirandola, Paolo Barone, Carmine Vitale

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: To estimate the prevalence of Pisa syndrome (PS) in patients with Parkinson disease (PD) and to assess the association between PS and demographic and clinical variables. Methods: In this multicenter cross-sectional study, consecutive outpatients with PD attending 21 movement disorders Italian tertiary centers were enrolled and underwent standardized clinical evaluation. PS was defined as trunk lateral deviation 10. Patients with PD were compared according to the presence of PS for several demographic and clinical variables. Results: Among 1,631 enrolled patients with PD, PS was detected in 143 patients (8.8%, 95% confidence interval 7.4%-10.3%). Patients with PS were older, had lower body mass index, longer disease duration, higher disease stages, and poorer quality of life. Falls were more frequent in the PS group as well as occurrence of "veering gait" (i.e., the progressive deviation toward one side when patient walked forward and backward with eyes closed). Patients with PS received higher daily levodopa equivalent daily dose and were more likely to be treated with combination of levodopa and dopamine agonists. Osteoporosis and arthrosis were significantly the most frequent associatedmedical conditions in patients with PS. Multiple explanatory variable logistic regression models confirmed the association of PSwith the following variables: Hoehn and Yahr stage, ongoing combined treatment with levodopa and dopamine agonist, associated medical conditions, and presence of veering gait. Conclusions: Our results suggest that PS is a relatively frequent and often disabling complication in PD, especially in the advanced disease stages. The association is dependent on a number of potentially relevant demographic and clinical variables.

Original languageEnglish
Pages (from-to)1769-1779
Number of pages11
JournalNeurology
Volume85
Issue number20
DOIs
Publication statusPublished - Nov 17 2015

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Parkinson Disease
Levodopa
Dopamine Agonists
Demography
Gait
Logistic Models
Joint Diseases
Movement Disorders
Osteoporosis
Body Mass Index
Outpatients
Cross-Sectional Studies
Quality of Life
Confidence Intervals

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Tinazzi, M., Fasano, A., Geroin, C., Morgante, F., Ceravolo, R., Rossi, S., ... Vitale, C. (2015). Pisa syndrome in Parkinson disease. Neurology, 85(20), 1769-1779. https://doi.org/10.1212/WNL.0000000000002122

Pisa syndrome in Parkinson disease. / Tinazzi, Michele; Fasano, Alfonso; Geroin, Christian; Morgante, Francesca; Ceravolo, Roberto; Rossi, Simone; Thomas, Astrid; Fabbrini, Giovanni; Bentivoglio, Annarita; Tamma, Filippo; Cossu, Giovanni; Modugno, Nicola; Zappia, Mario; Volontè, Maria Antonietta; Dallocchio, Carlo; Abbruzzese, Giovanni; Pacchetti, Claudio; Marconi, Roberto; Defazio, Giovanni; Canesi, Margherita; Cannas, Antonino; Pisani, Antonio; Mirandola, Rina; Barone, Paolo; Vitale, Carmine.

In: Neurology, Vol. 85, No. 20, 17.11.2015, p. 1769-1779.

Research output: Contribution to journalArticle

Tinazzi, M, Fasano, A, Geroin, C, Morgante, F, Ceravolo, R, Rossi, S, Thomas, A, Fabbrini, G, Bentivoglio, A, Tamma, F, Cossu, G, Modugno, N, Zappia, M, Volontè, MA, Dallocchio, C, Abbruzzese, G, Pacchetti, C, Marconi, R, Defazio, G, Canesi, M, Cannas, A, Pisani, A, Mirandola, R, Barone, P & Vitale, C 2015, 'Pisa syndrome in Parkinson disease', Neurology, vol. 85, no. 20, pp. 1769-1779. https://doi.org/10.1212/WNL.0000000000002122
Tinazzi M, Fasano A, Geroin C, Morgante F, Ceravolo R, Rossi S et al. Pisa syndrome in Parkinson disease. Neurology. 2015 Nov 17;85(20):1769-1779. https://doi.org/10.1212/WNL.0000000000002122
Tinazzi, Michele ; Fasano, Alfonso ; Geroin, Christian ; Morgante, Francesca ; Ceravolo, Roberto ; Rossi, Simone ; Thomas, Astrid ; Fabbrini, Giovanni ; Bentivoglio, Annarita ; Tamma, Filippo ; Cossu, Giovanni ; Modugno, Nicola ; Zappia, Mario ; Volontè, Maria Antonietta ; Dallocchio, Carlo ; Abbruzzese, Giovanni ; Pacchetti, Claudio ; Marconi, Roberto ; Defazio, Giovanni ; Canesi, Margherita ; Cannas, Antonino ; Pisani, Antonio ; Mirandola, Rina ; Barone, Paolo ; Vitale, Carmine. / Pisa syndrome in Parkinson disease. In: Neurology. 2015 ; Vol. 85, No. 20. pp. 1769-1779.
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T1 - Pisa syndrome in Parkinson disease

AU - Tinazzi, Michele

AU - Fasano, Alfonso

AU - Geroin, Christian

AU - Morgante, Francesca

AU - Ceravolo, Roberto

AU - Rossi, Simone

AU - Thomas, Astrid

AU - Fabbrini, Giovanni

AU - Bentivoglio, Annarita

AU - Tamma, Filippo

AU - Cossu, Giovanni

AU - Modugno, Nicola

AU - Zappia, Mario

AU - Volontè, Maria Antonietta

AU - Dallocchio, Carlo

AU - Abbruzzese, Giovanni

AU - Pacchetti, Claudio

AU - Marconi, Roberto

AU - Defazio, Giovanni

AU - Canesi, Margherita

AU - Cannas, Antonino

AU - Pisani, Antonio

AU - Mirandola, Rina

AU - Barone, Paolo

AU - Vitale, Carmine

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N2 - Objective: To estimate the prevalence of Pisa syndrome (PS) in patients with Parkinson disease (PD) and to assess the association between PS and demographic and clinical variables. Methods: In this multicenter cross-sectional study, consecutive outpatients with PD attending 21 movement disorders Italian tertiary centers were enrolled and underwent standardized clinical evaluation. PS was defined as trunk lateral deviation 10. Patients with PD were compared according to the presence of PS for several demographic and clinical variables. Results: Among 1,631 enrolled patients with PD, PS was detected in 143 patients (8.8%, 95% confidence interval 7.4%-10.3%). Patients with PS were older, had lower body mass index, longer disease duration, higher disease stages, and poorer quality of life. Falls were more frequent in the PS group as well as occurrence of "veering gait" (i.e., the progressive deviation toward one side when patient walked forward and backward with eyes closed). Patients with PS received higher daily levodopa equivalent daily dose and were more likely to be treated with combination of levodopa and dopamine agonists. Osteoporosis and arthrosis were significantly the most frequent associatedmedical conditions in patients with PS. Multiple explanatory variable logistic regression models confirmed the association of PSwith the following variables: Hoehn and Yahr stage, ongoing combined treatment with levodopa and dopamine agonist, associated medical conditions, and presence of veering gait. Conclusions: Our results suggest that PS is a relatively frequent and often disabling complication in PD, especially in the advanced disease stages. The association is dependent on a number of potentially relevant demographic and clinical variables.

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