Abstract
Purpose
To investigate the incidence of retrocollis and to determine its clinical correlates
in patients with idiopathic Parkinson's disease (PD).
Methods
Seventy-four patients with PD at Hoehn and Yahr stage 5 were examined for abnormal
neck postures and were classified according to neck posture. Differences in age, age
at PD onset, disease duration, years from PD onset to Hoehn and Yahr stage 5, cognitive
state, the levodopa equivalent dose (LED) for dopaminergic drugs, and rigidity of
the neck and upper and lower extremities were examined to determine the clinical correlates
of abnormal neck posture. We also evaluated retrocollis in 356 patients with PD at
Hoehn and Yahr stage 1, 2, 3, and 4 and 65 age matched normal controls.
Results
Of the 74 patients with PD at Hoehn and Yahr stage 5 examined, 21 (28.4%) had retrocollis,
3 (4.1%) had antecollis, and 1 (1.4%) had antecollis and torticollis. Whereas, only
one patient had retrocollis in PD patients at Hoehn and Yahr stage 4 and under. Patients
with antecollis were significantly younger than those with normal neck posture and
retrocollis. There were no differences in age at PD onset, disease duration, sex,
years from PD motor symptom onset to Hoehn and Yahr stage 5, cognitive state, or LED
between patients with and without abnormal neck postures. Neck rigidity scores were
significantly higher in patients with retrocollis and antecollis than in those with
normal neck posture.
Conclusions
Retrocollis is not rare in patients with PD at Hoehn and Yahr stage 5, and the incidence
appeared to increase as axial rigidity increased.
Keywords
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Article info
Publication history
Published online: November 13, 2012
Accepted:
October 18,
2012
Received in revised form:
September 26,
2012
Received:
July 30,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
