Camptocormia in Parkinson's Disease: A Muscle Disease Due to Dysregulated Proprioceptive Polysynaptic Reflex Arch.

Walter J Schulz-Schaeffer

doi:10.3389/fnagi.2016.00128

Walter J Schulz-Schaeffer

Open Access

https://doi.org/10.3389/fnagi.2016.00128

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Abstract

Camptocormia (from the Greek “kamptein” = to bend and “kormos” = trunk) is an anterior flexion of the thoracolumbar spine while standing, walking, or sitting that disappears in the supine position. The syndrome, also known as “bent spine syndrome,” occurs in nearly 10% of idiopathic Parkinson's disease (iPD) patients (Yoritaka et al., 2013), but also in other neurodegenerative diseases and may occur in myopathies with axial involvement, in all forms of myositis, in dystonia, as a pharmacological side effect or as functional disorder. It causes marked impairment in quality of life and often leads to social isolation. The pathophysiology of camptocormia is as heterogenous as the causes of underlying diseases are, but recent work has provided some insights into the pathophysiology of PD-associated camptocormia and opened options for treatement. These findings show, how important it is to understand the interaction between muscle innervation, Golgi tendon organ and the central nervous system in regulating muscle tone.

Highlights

Reviewed by: Caroline Sewry, Great Ormond Street Hospital, UK Marie-Bernadette Delisle, Toulouse III University - Paul Sabatier, France
These findings show, how important it is to understand the interaction between muscle innervation, Golgi tendon organ and the central nervous system in regulating muscle tone
Several small case series including muscle biopsies have been published, and myositis, mitochondrial disturbances, dystonia, or myopathy have been discussed as etiologies of the syndrome

Summary

Introduction

Reviewed by: Caroline Sewry, Great Ormond Street Hospital, UK Marie-Bernadette Delisle, Toulouse III University - Paul Sabatier, France. Several small case series including muscle biopsies have been published, and myositis, mitochondrial disturbances, dystonia, or myopathy have been discussed as etiologies of the syndrome. In the beginning of this century, larger series of paraspinal muscle biopsies in iPD patiens suffering from camptocormia revealed myopathic changes (Margraf et al, 2010; Spuler et al, 2010).

Results

Conclusion