Predictors of camptocormia in patients with Parkinson's disease: A prospective study from southwest China

Background: Camptocormia is becoming increasingly recognized as a prominent phenomenon in Parkinson's disease (PD). Objective: This study aims to investigate the clinical predictors of future camptocormia in a cohort of PD patients. Methods: A total of 263 PD patients without camptocormia were prospectively monitored for approximately 3 years. The end-point was the occurrence of camptocormia. Results: Overall, camptocormia was observed in 23 patients (8.7%) during the study period. The following variables including the proportion of males; age; disease duration; total levodopa equivalent daily dosage; Unified PD Rating Scale (UPDRS) III score; Hoehn and Yahr stage; the percentages of festination, freezing of gait and falls; and the subscores (e.g., "problems having sex") and frequencies (e.g., "forget to do things") of the Non-Motor Symptoms Scale were significantly higher in patients with camptocormia compared to those variables in patients without camptocormia (P < 0.05). Patients with camptocormia showed lower "orientation" subscore of the Montreal Cognitive Assessment scale than patients without camptocormia (P< 0.05). The binary logistic regression model indicated that the presence of camptocormia was associated with male sex (OR = 6.758, P=0.001), a higher UPDRS III score (OR=1.099, P=0.001), a higher sexual dysfunction score (OR = 1.033, P=0.038) and a lower orientation score (OR = 0.392, P = 0.018). Conclusions: Camptocormia may emerge as PD progresses. Male patients and those with sexual dysfunction or disorientation are likely to present with camptocormia in the future. (C) 2018 Elsevier Ltd. All rights reserved.