Camptocormia, or "
bent spine syndrome", may occur in various
movement disorders such as
primary dystonia or
idiopathic Parkinson's disease (PD). Although
deep brain stimulation (DBS) is an established treatment in refractory
primary dystonia and advanced PD, few data are available on the effect of DBS on
camptocormia comparing these two conditions. Seven patients (4 with
dystonia, 3 with PD; mean age 60.3 years at surgery, range 39-73 years) with
camptocormia were included in the study. Five patients underwent bilateral GPi DBS and two patients underwent bilateral STN DBS guided by CT-stereotactic surgery and
microelectrode recording. Pre- and postoperative motor assessment included the BFM in the
dystonia patients and the UPDRS in the PD patients. Severity of
camptocormia was assessed by the BFM subscore for the trunk at the last available follow-up at a mean of 17.3 months (range 9-36 months). There were no surgical complications. In the four patients with
dystonia there was a mean improvement of 53% in the BFM motor score (range 41-79%) and of 63% (range 50-67%) in the BFM subscore for the trunk at the last available follow-up (mean 14.3 months, range 9-18 months). In the three patients with
camptocormia in PD who underwent bilateral STN DBS (2 patients) or pallidal DBS (1 patient), the PD symptoms improved markedly (mean improvement in the UPDRS motor subscore stimulation on/medication off 55%, range 49-61%), but there was no or only mild improvement of
camptocormia in the two patients who underwent STN DBS, and only moderate improvement in the patient with GPi DBS at the last available follow-up (mean 21 months, range 12-36 months). GPi DBS is an effective treatment for
camptocormia in
dystonia. The response of
camptocormia to chronic STN or GPi DBS in PD is more heterogenous. The latter may be due to a variety of causes and needs further clarification.