Table 3.
Studies of DBS for treating camptocormia in PD
| Study | Type of study |
Age (years)/sex |
PD duration (years) |
Target of bilateral DBS |
UPDRS III (preoperative) |
UPDRS III (postoperative with ‘on’ stimulation) |
Outcomes of postural abnormality | Efficacy of DBS on camptocormia |
Adverse effects |
|---|---|---|---|---|---|---|---|---|---|
| Schäbitz et al10 | Case report | 61/M | 30 | STN | n | n | No improvement | Not effective | n |
| 65/M | 12 | STN | n | n | No improvement | Not effective | n | ||
| Azher and Jankovic58 | Case series | n/n | n | STN | n | n | No improvement | Not effective | n |
| Micheli et al76 | Case report | 62/M | 9 | GPi | On med=24 Off med=52 |
3 months after DBS; off med=37 | Immediate effect after DBS that lasted up to 3 weeks; after that, effect wore off 6 months after DBS; obvious improvement of posture 14 months after DBS; only a slight forward flexion of the trunk |
Effective | No |
| Yamada et al70 | Case report | 71/F | 11 | STN | On med=38 Off med=47 |
3 months after DBS; on med=12 Off med=12 |
Immediate effect after DBS lasting for more than 20 months | Effective | No |
| Hellmann et al71 | Case report | 53/M | 25 | STN | On med=47* Off med=91* |
10 months after DBS; on med=29* Off med=58* |
Immediate effect after DBS, lasting at least 10 months | Effective | No |
| Sako et al72 | Case series | 60/F | 11 | STN | On med=38 Off med=47 |
46 months after DBS; on med=20 Off med=20 |
T-L angle (degrees); baseline=90 46 months=30 |
Effective | n |
| 54M | 10 | STN | On med=56 Off med=56 |
15 months after DBS; on med=15 Off med=15 |
T-L angle (degrees); baseline=90 15 months=30 |
Effective | n | ||
| 47/F | 8 | STN | On med=32 Off med=67 |
18 months after DBS; on med=32 Off med=32 |
T-L angle (degrees); baseline=90 18 months=10 |
Effective | n | ||
| 48/F | 5 | STN | On med=33 Off med=33 |
5 months after DBS; on med=5 Off med=5 |
T-L angle (degrees); baseline=50 5 months=10 |
Effective | n | ||
| 54/M | 11 | STN | On med=25 Off med=25 |
8 months after DBS; on med=7 Off med=7 |
T-L angle (degrees); baseline=60 8 months=10 |
Effective | n | ||
| 44/F | 9 | STN | On med=62 Off med=62 |
9 months after DBS; on med=11 Off med=11 |
T-L angle (degrees); baseline=60 19 months=10 |
Effective | n | ||
| Upadhyaya et al78 | Case report | 59/M | n | STN | n | n | 2 years after DBS: no improvement of camptocormia | Not effective | n |
| 59/M | n | GPi | n | n | 15 months after DBS: no improvement of camptocormia | Not effective | n | ||
| Umemura et al73 | Case series | 63/F | 19 | STN | On med=26 Off med=34 |
1 month after DBS; off med=21 12 months after DBS; off med=26 |
UPDRS item 28†; baseline=2 1 month=1 12 months=2 |
Not effective | No |
| 60/F | 20 | STN | On med=22 Off med=70 |
1 month after DBS; off med=11 12 months after DBS; off med=13 |
UPDRS item 28†; baseline=2 1 month=1 12 months=1 |
Effective | No | ||
| 59/M | 8 | STN | On med=9 Off med=29 |
1 month after DBS; off med=3 12 months after DBS; off med=4 |
UPDRS item 28†; 1 month=1 12 months=1 |
Effective | No | ||
| 63/F | 20 | STN | On med=20 Off med=40 |
1 month after DBS; off med=3 12 months after DBS; off med=10 |
UPDRS item 28†; baseline=2 1 month=1 12 months=1 |
Effective | No | ||
| 63/F | 13 | STN | On med=32 Off med=55 |
1 months after DBS; off med=22 12 months after DBS; off med=28 |
UPDRS item 28†; baseline=2 1 month=2 12 months=1 |
Effective | No | ||
| 79/M | 15 | STN | On med=42 Off med=50 |
1 months after DBS; off med=18 12 months after DBS; off med=27 |
UPDRS item 28†; baseline=2 1 month=2 12 months=2 |
Not effective | No | ||
| 66/F | 19 | STN | On med=42 Off med=79 |
1 months after DBS; off med=17 12 months after DBS; off med=21 |
UPDRS item 28†; baseline=3 1 month=3 12 months=2 |
Effective | No | ||
| 68/F | 10 | STN | On med=36 Off med=48 |
1 month after DBS; off med=35 12 months after DBS; off med=34 |
UPDRS item 28†; baseline=4 1 month=4 12 months=4 |
Not effective | No | ||
| Capelle et al19 | Case series | 73/M | 12 | STN | On med=21 Off med=43 |
16 months after DBS; off med=20 | BFMDRS-trunk‡; baseline=8 16 months=6 |
Effective | No |
| 65/M | 15 | STN | On med=15 Off med=36 |
12 months after DBS; off med=14 | BFMDRS-trunk‡; baseline=12 12 months=12 |
Not effective | No | ||
| 64/M | 10 | GPi | On med=25 Off med=47 |
36 months after DBS; off med=24 | BFMDRS-trunk‡; baseline=9 36 months=6 |
Effective | No | ||
| Asahi et al74 | Case series | 60/F | 13 | STN | On med=23 Off med=25 |
18 months after DBS; on med=7 Off med=7 |
T-L angle (degrees); baseline=50 18 months=28 |
Effective | n |
| 69/M | 12 | STN | On med=25 Off med=52 |
21 months after DBS; on med=20 Off med=26 |
T-L angle (degrees); baseline=40 21 months=21 |
Effective | n | ||
| 61/F | 12 | STN | On med=26 Off med=26 |
40 months after DBS; on med=15 Off med=25 |
T-L angle (degrees); baseline=36 40 months=23 |
Effective | n | ||
| 61/F | 9 | STN | On med=16 Off med=34 |
24 months after DBS; on med=16 Off med=22 |
T-L angle (degrees); baseline=50 24 months=51 |
Not effective | n | ||
| Thani et al77 | Case report | 57/F | 7 | GPi | On med=3 Off med=25 |
14 months after DBS; on med=14 Off med=14 |
2 months after DBS; obvious improvement of posture S-H-K angle (degrees); baseline=133 12 months=160 |
Effective | n |
| Lyons et al75 | Case report | 63/F | 1 | STN | On med=18 Off med=35 |
3 months after DBS; on med=15 Off med=20 |
T-L angle improved ~90% at 3 months after DBS | Effective | n |
| Schulz-Schaeffer Et al102 | Case series | Responders; n=13; age=65.8§; M:F=11:2 Nonresponders; n=12; age=68.6§; M:F=10:2 |
Responders=14.7§ Nonresponders=17§ |
STN=24; GPi=1 | Responders; On med=21.4§ Off med=n Non-responders On med=24.1§ Off med=n |
6–12 months after DBS; responders; on med=12.9§ Off med=n Non-responders; on med=18.2§ Off med=n |
Responder; 67–100% improvement of degree of trancal flexion within an average follow-up period of 30 months; VAS-handicap; 48% improvement; VAS-pain; 39.9% improvement Non-responders; no improvement of all outcomes (including 1 case on whom GPi stimulation was performed) |
Effective | n |
*
Total score of all part of UPDRS.
†
Postural abnormality sub-score of UPDRS (score is ranged from 0; normal to 4; severe).
‡
Trunk sub-score of BFMDRS (score is ranged from 0–12).
§
Reported as a mean of age, duration of PD, and scores of UPDRS III.
BFMDRS-trunk, Burke-Fahn-Marsden Dystonia Rating Scale, trunk subscore; DBS, deep brain stimulation; F, female; GPi, globus pallidus interna; M, male; med, medication; n, not reported; PD, Parkinson’s disease; S-H-K angle, shoulder-hip-knee angle; STN, subthalamic nucleus; T-L angle, thoracolumbar angle; UPDRS III, Unified PD Rating Scale part III, motor subscore; VAS, visual analogue scales.