Levodopa and Posture - Quantification of Trunk Performance in Parkinson’s Disease (P3.063)

Background: Postural disorders are frequent complications in patients with Parkinson’s disease (PD) and adversely impact their overall functioning, disrupt gait, increase falls, and produce pain or discomfort. It is considered that axial spine deformities in PD are in general not responsive to the common anti Parkinson’s treatments. Objectives: To quantitatively assess the effect of levodopa on posture in de novo patients and in patients with response fluctuations. Methods: 20 patients with early onset PD and 24 patients with response fluctuations were recruited. Motor symptoms were assessed by the motor part of the UPDRS score. A new handheld mechanical device (SpinalMouse) was used to assess spinal mobility, posture, and range of motion. Patients were examined before starting treatment with levodopa and 3 months thereafter. Patients with response fluctuations were examined before and 30 minutes after their regular dose of levodopa. Variables collected include thoracic and lumbar spinal curvature, AUC of thoracic curvature and sacral and total spinal inclination. Results: In patients newly treated with levodopa total spine inclination and lumbar inclination was significantly improved after 3 months of treatment (7.88 ± 3.58 vs. 5.88 ± 4.02; t=0.16; -8.38 ± 3.79 vs. -14.38 ± 4.5, t=0.02; 15.25 ± 2.0 vs. 7.13 ± 2.89, t=0.001 respectively) but no significant changes were detected in regard to their thoracic spine flexibility. In patients with response fluctuations there was a significant difference in sacral inclination, thoracic spine kyphosis, and total spine inclination between the "off" and "on" states (6.1 ± 2.1 vs. 2.3 ± 2.1; t=0.009; 54.7 ± 3.5 vs. 50.5 ± 3.4; t=0.04 and 13.2 ± 1.5 vs. 9.1 ± 1.3; t=0.03 respectively). Conclusions: Spinal mobility was significantly altered by levodopa indicating a possible treatment effect of levodopa in anterior flexion of the thoracolumbar spine. It is possible that the mechanism is improvement of axial rigidity. Disclosure: Dr. Benninger has nothing to disclose. Dr. Khlebtovsky has nothing to disclose. Dr. Roditi has nothing to disclose. Dr. Melamed has received personal compensation for activities with Brainstorm Cell Therapeutics Ltd. as founder. Dr. Djaldetti has nothing to disclose.