Abstract Details

Title Treatment of Camptocormia in Parkinsonism: A Comparison of Different Interventions in a Single Center

Topic Movement Disorders

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-001

Background Camptocormia is a complex, highly disabling condition in people with Parkinsonism, and effective treatments are lacking. Treatment outcomes have been incompletely characterized to date.

Objective To evaluate (1) the clinical features of Camptocormia and (2) the efficacy of various treatments for Camptocormia of Parkinson’s Disease (PD) and Atypical Parkinsonism (AP).

Design/Methods A retrospective chart review was performed on 19 consecutive patients with diagnoses of both camptocormia and Parkinsonism at a large medical center. Treatment interventions included dopamine replacement therapy (DRT), physical therapy, steroids, deep brain stimulation (DBS) of subthalamic nucleus (STN) or globus pallidus interna (GPi), and spinal fixation surgery. Camptocormia severity and treatment outcomes were assessed with Clinical Global Impression Severity and Change Scales (GCI-S and CGI-C, respectively). Treatment responders were defined as those with CGI-C≤3 (with CGI-C=3 indicating mild improvement).

Results 58% of patients were male (n=9), with a median age of 74 years and median disease duration of 11 years. All 19 patients had camptocormia in addition to the following types of Parkinsonism: PD (68%, n=13), Multiple System Atrophy (MSA, 21%, n=4), or both PD and MSA features (11%, n=2). Camptocormia responded to DRT in 6% of cases (n=1/18, CGI-C=3), to physical therapy in 22% (n=4/18, median CGI-C=3), to steroids in 33% (n=1/3, CGI-C=2), to DBS in 33% (n=1/3, CGI-C=3), and to surgery in 56% (n=5/9, median CGI-C=2). Of the patients who underwent surgery, 67% (n=6) required ICU-level post-operative care, 44% (n=4) required inpatient hospital rehabilitation, and 44% (n=4) ultimately required >1 additional surgery.

Conclusions Camptocormia remains a very challenging condition to treat. In this study, treatment outcomes for camptocormia in Parkinsonism were highly variable and unpredictable. Further research is desperately needed to improve understanding of the various mechanisms underlying camptocormia in order to provide effective management for this disabling condition.

Authors/Disclosures
Carly J. Olszewski PRESENTER	Ms. Olszewski has nothing to disclose.
Jessica Tate, MD (Atrium Health Wake Forest Baptist)	The institution of Dr. Tate has received research support from Ipsen. The institution of Dr. Tate has received research support from Boston Scientific. The institution of Dr. Tate has received research support from Revance Therapeutics. The institution of Dr. Tate has received research support from CHDI Foundation. The institution of Dr. Tate has received research support from NINDS. The institution of Dr. Tate has received research support from Michael J. Fox Foundation.
	No disclosure on file
	No disclosure on file
Mustafa S. Siddiqui, MD, FAAN	Dr. Siddiqui has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Boston Scientific Neuromodulation. Dr. Siddiqui has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Siddiqui has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for United States Department of Justice. The institution of Dr. Siddiqui has received research support from Boston Scientific Neuromodulation. The institution of Dr. Siddiqui has received research support from Abbvie. Dr. Siddiqui has received research support from Michael J. Fox Foundation. The institution of Dr. Siddiqui has received research support from National Institute of Health .