Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations

Background: Pisa syndrome (PS) is a lateral flexion of the trunk frequently associated with Parkinson's disease (PD). The pathophysiology of PS remains unclear, but the role of cognitive deficits has been postulated.Methods: We included 12 consecutive PD patients with PS (PS+) and 12 PD patient...

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Main Authors: Carlo Alberto Artusi, Elisa Montanaro, Sara Tuttobene, Alberto Romagnolo, Maurizio Zibetti, Leonardo Lopiano
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-05-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fneur.2019.00577/full
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author Carlo Alberto Artusi
Elisa Montanaro
Sara Tuttobene
Alberto Romagnolo
Maurizio Zibetti
Leonardo Lopiano
author_facet Carlo Alberto Artusi
Elisa Montanaro
Sara Tuttobene
Alberto Romagnolo
Maurizio Zibetti
Leonardo Lopiano
author_sort Carlo Alberto Artusi
collection DOAJ
description Background: Pisa syndrome (PS) is a lateral flexion of the trunk frequently associated with Parkinson's disease (PD). The pathophysiology of PS remains unclear, but the role of cognitive deficits has been postulated.Methods: We included 12 consecutive PD patients with PS (PS+) and 12 PD patients without PS (PS–) matched for gender, age, level of education, PD duration, and PD stage. As primary aim, we compared the neuropsychological scores of 16 tests evaluating 6 cognitive domains between PS+ and PS–. Additionally, we evaluated the presence of misperception of the trunk position in PS+, defined as a mismatch between the objective vs. subjective evaluation of the trunk bending angle >5°, and analyzed whether a correlation exists between the misperception of the trunk position and alterations in the visual-spatial abilities.Results: PS+ group showed significantly worse performances in the visual-spatial abilities (p: 0.008), attentional domain (p: 0.001), and language domain (p: 0.023). No differences were found in the other cognitive domains nor in the general cognitive assessment. All PS+ patients showed a misperception of the trunk position, with an average underestimation of the trunk bending angle of 11.7° ± 4.3. The degree of misperception of the trunk position showed a trend toward a correlation with the visual-spatial scores (p: 0.089).Conclusions: The study reveals an association between PS and specific cognitive alterations, suggesting a possible link between the abnormal posture of PD patients with PS and their cognitive functions.
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spelling doaj.art-2e1d2710279b4166b005a37f1e3e51362022-12-22T02:06:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-05-011010.3389/fneur.2019.00577461691Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive AlterationsCarlo Alberto ArtusiElisa MontanaroSara TuttobeneAlberto RomagnoloMaurizio ZibettiLeonardo LopianoBackground: Pisa syndrome (PS) is a lateral flexion of the trunk frequently associated with Parkinson's disease (PD). The pathophysiology of PS remains unclear, but the role of cognitive deficits has been postulated.Methods: We included 12 consecutive PD patients with PS (PS+) and 12 PD patients without PS (PS–) matched for gender, age, level of education, PD duration, and PD stage. As primary aim, we compared the neuropsychological scores of 16 tests evaluating 6 cognitive domains between PS+ and PS–. Additionally, we evaluated the presence of misperception of the trunk position in PS+, defined as a mismatch between the objective vs. subjective evaluation of the trunk bending angle >5°, and analyzed whether a correlation exists between the misperception of the trunk position and alterations in the visual-spatial abilities.Results: PS+ group showed significantly worse performances in the visual-spatial abilities (p: 0.008), attentional domain (p: 0.001), and language domain (p: 0.023). No differences were found in the other cognitive domains nor in the general cognitive assessment. All PS+ patients showed a misperception of the trunk position, with an average underestimation of the trunk bending angle of 11.7° ± 4.3. The degree of misperception of the trunk position showed a trend toward a correlation with the visual-spatial scores (p: 0.089).Conclusions: The study reveals an association between PS and specific cognitive alterations, suggesting a possible link between the abnormal posture of PD patients with PS and their cognitive functions.https://www.frontiersin.org/article/10.3389/fneur.2019.00577/fullPisa syndromeParkinson's diseasecognitionneuropsychologyself-perception
spellingShingle Carlo Alberto Artusi
Elisa Montanaro
Sara Tuttobene
Alberto Romagnolo
Maurizio Zibetti
Leonardo Lopiano
Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
Frontiers in Neurology
Pisa syndrome
Parkinson's disease
cognition
neuropsychology
self-perception
title Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
title_full Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
title_fullStr Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
title_full_unstemmed Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
title_short Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations
title_sort pisa syndrome in parkinson s disease is associated with specific cognitive alterations
topic Pisa syndrome
Parkinson's disease
cognition
neuropsychology
self-perception
url https://www.frontiersin.org/article/10.3389/fneur.2019.00577/full
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