Background: Camptocormia in Parkinson's disease (PD) is unresponsive to various therapies and induced difficulties in their day-to-day life. Objective: This study, an open trial, was aimed at assessing the efficacy of selegiline in the treatment of mild camptocormia in PD patients. Methods: Participants were administered 5 mg of selegiline for the first 8 weeks and 7.5 mg for the second 8 weeks. Results: As primary endpoints, the degree of thoracolumbar anteflexion decreased from 23.2° (mean) (11.8° (SD)) at baseline to 18.3° (7.1°) at 16 weeks, and the area of postural sway measured using a Gravicorder increased. However, the differences were not significant. Thoracolumbar anteflexion improved in 60% of the participants. Conclusions: In this study, 60% of the participants showed an improvement in anteflexion of the thoracolumbar spine with selegiline, but the change in the degree of anteflexion was 5°, which was not statistically significant. Participants with significant improvement in thoracolumbar anteflexion had an increased postural sway. This change was induced by a decrease in truncal muscle tonus or change in the center of gravity. This study combined the study of anteflexion and stability, and provides information on the treatment of short-term or mild camptocormia.

1.
Ashour R, Jankovic J: Joint and skeletal deformities in Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy. Mov Disord 2006;21:1856-1863.
2.
Lepoutre AC, Devos D, Blanchard-Dauphin A, Pardessus V, Maurage CA, Ferriby D, Hurtevent JF, Cotten A, Destée A, Defebvre L: A specific clinical pattern of camptocormia in Parkinson's disease. J Neurol Neurosurg Psychiatry 2006;77:1229-1234.
3.
Tiple D, Fabbrini G, Colosimo C, Ottaviani D, Camerota F, Defazio G, Berardelli A: Camptocormia in Parkinson disease: an epidemiological and clinical study. J Neurol Neurosurg Psychiatry 2009;80:145-148.
4.
Abe K, Uchida Y, Notani M: Camptocormia in Parkinson's disease. Parkinsons Dis 2010;pii:267640.
5.
Seki M, Takahashi K, Koto A, Mihara B, Morita Y, Isozumi K, Ohta K, Muramatsu K, Gotoh J, Yamaguchi K, Tomita Y, Sato H, Nihei Y, Iwasawa S, Suzuki N; Keio Parkinson's Disease Database: Camptocormia in Japanese patients with Parkinson's disease: a multicenter study. Mov Disord 2011;26:2567-2571.
6.
Yoritaka A, Shimo Y, Takanashi M, Fukae J, Hatano T, Nakahara T, Miyamato N, Urabe T, Mori H, Hattori N: Motor and non-motor symptoms of 1453 patients with Parkinson's disease: prevalence and risks. Parkinsonism Relat Disord 2013;19:725-731.
7.
Song W, Guo X, Chen K, Huang R, Zhao B, Cao B, Chen Y, Shang HF: Camptocormia in Chinese patients with Parkinson's disease. J Neurol Sci 2014;337:173-175.
8.
Benatru I, Vaugoyeau M, Azulay JP: Postural disorders in Parkinson's disease. Neurophysiol Clin 2008;38:459-465.
9.
Doherty KM, van de Warrenburg BP, Peralta MC, Silveira-Moriyama L, Azulay JP, Gershanik OS, Bloem BR: Postural deformities in Parkinson's disease. Lancet Neurol 2011;10:538-549.
10.
Furusawa Y, Mukai Y, Kobayashi Y, Sakamoto T, Murata M: Role of the external oblique muscle in upper camptocormia for patients with Parkinson's disease. Mov Disord 2012;27:802-803.
11.
Ou R, Guo X, Song W, Cao B, Wei Q, Shao N, Zhao B, Shang H: Characteristics of non-motor symptoms in patients with Parkinson's disease exhibiting camptocormia. Gait Posture 2014;40:447-450.
12.
Arii Y, Sawada Y, Kawamura K, Miyake S, Taichi Y, Izumi Y, Kuroda Y, Inui T, Kaji R, Mitsui T: Immediate effect of spinal magnetic stimulation on camptocormia in Parkinson's disease. J Neurol Neurosurg Psychiatry 2014;85:1221-1226.
13.
Furusawa Y, Hanakawa T, Mukai Y, Aihara Y, Taminato T, Iawata Y, Takei T, Sakamoto T, Murata M: Mechanism of camptocormia in Parkinson's disease analyzed by tilt table-EMG recording. Parkinsonism Relat Disord 2015;21:765-770.
14.
Heinonen EH, Rinne UK, Tuominen J: Selegiline in the treatment of daily fluctuations in disability of parkinsonian patients with long-term levodopa treatment. Acta Neurol Scand Suppl 1989;126:113-118.
15.
Kondo T, Goto I, Kowa H, Yanagisawa N, Kanazawa I, Ogawa N, Mizuno Y: Clinical effects of FPF1100 (selegiline) for the patients with Parkinson's disease; randomized controlled double blind trial. Igaku No Ayumi 1996;177:157-231.
16.
Hughes AJ, Daniel SE, Kilford L, Lees AJ: Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181-184.
17.
Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE: Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord 2010;25:2649-2653.
18.
Srivanitchapoom P, Hallett M: Camptocormia in Parkinson's disease: definition, epidemiology, pathogenesis and treatment modalities. J Neurol Neurosurg Psychiatry 2016;87:75-85.
19.
Schulz-Schaeffer WJ, Margraf NG, Munser S, Wrede A, Buhmann C, Deuschl G, Oehlwein C: Effect of neurostimulation on camptocormia in Parkinson's disease depends on symptom duration. Mov Disord 2015;30:368-372.
20.
Ninomiya S, Morita A, Teramoto H, Akimoto T, Shiota H, Kamei S: Relationship between postural deformities and frontal function in Parkinson's disease. Parkinsons Dis 2015;2015:462143.
21.
Schoneburg B, Mancini M, Horak F, Nutt JG: Framework for understanding balance dysfunction in Parkinson's disease. Mov Disord 2013;28:1474-1482.
22.
Rocchi L, Chiari L, Horak FB: Effects of deep brain stimulation and levodopa on postural sway in Parkinson's disease. J Neurol Neurosurg Psychiatry 2002;73:267-274.
23.
Mitchell SL, Collins JJ, De Luca CJ, Burrows A, Lipsitz LA: Open-loop and closed-loop postural control mechanisms in Parkinson's disease: increased mediolateral activity during quiet standing. Neurosci Lett 1995;197:133-136.
24.
Margraf NG, Rohr A, Granert O, Hampel J, Drews A, Deuschl G: MRI of lumbar trunk muscles in patients with Parkinson's disease and camptocormia. J Neurol 2015;262:1655-1664.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.