Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management

Axial postural abnormalities are common and disabling motor complications of Parkinson's disease (PD) and parkinsonism. They consist of abnormal trunk or neck postures in the upright position, often interfering with daily life activities.1-5 A high number of patients with PD may develop one or more axial postural abnormalities, which may begin as minor forms, almost universal in persons with parkinsonism (eg, minor flexed posture of the trunk and lower limbs), and progress to severe forms such as camptocormia, antecollis, or Pisa syndrome in over 20% of patients,1 although the definitions of severe axial postural abnormalities were purely based on subjective/expert opinion. Drug-induced parkinsonism or progressive supranuclear palsy may also present axial postural abnormalities, and in multiple system atrophy these symptoms…