Funding agencies: This study was supported by grants from France Parkinson Association.
The pathogenesis of Pisa syndrome in Parkinson's disease
Article first published online: 7 JUN 2014
© 2014 International Parkinson and Movement Disorder Society
Volume 29, Issue 9, pages 1100–1107, August 2014
How to Cite
Castrioto, A., Piscicelli, C., Pérennou, D., Krack, P. and Debû, B. (2014), The pathogenesis of Pisa syndrome in Parkinson's disease. Mov. Disord., 29: 1100–1107. doi: 10.1002/mds.25925
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 18 AUG 2014
- Article first published online: 7 JUN 2014
- Manuscript Accepted: 27 APR 2014
- Manuscript Revised: 17 APR 2014
- Manuscript Received: 29 MAR 2014
- Parkinson's disease;
- postural deviation;
- basal ganglia;
- sensory integration;
Postural abnormalities such as postural deviations affect nearly all patients with advanced Parkinson's disease and represent an important source of disability. Although their existence has long been known, their management remains a challenge as they respond poorly to medication, brain surgery, or physiotherapy. Improving management strategies will require better understanding of the mechanisms underlying such postural deformities.
In this review on the pathophysiology of Pisa syndrome, we examine the data supporting the central and peripheral hypotheses that attempt to explain these lateral trunk deviations. Although the pathophysiology is very probably multifactorial, the bulk of the data supports central, rather than peripheral, hypotheses. The central hypotheses that are best supported by both animal studies and clinical data include asymmetry of basal ganglia output and abnormalities in the central integration of sensory information. Further studies are needed to elucidate the pathophysiology underlying Pisa syndrome. © 2014 International Parkinson and Movement Disorder Society