Article Dans Une Revue Parkinsonism & Related Disorders Année : 2026

Motor complications and postural abnormalities interplay in Parkinson's disease

1 CIC 1436 - Centre d'investigation clinique de Toulouse
2 ToNIC - Toulouse NeuroImaging Center
3 ICM - Institut du Cerveau = Paris Brain Institute
4 CEPHEPI - Centre de pharmacoépidémiologie AP-HP
5 NeuroToul - Centre d’Excellence en Maladies Neurodégénératives
6 U955 Inserm - UPEC - IMRB - "NeuroPsychologie Interventionnelle" [Créteil]
7 LilNCog - Lille Neurosciences & Cognition - U 1172
8 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
9 Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM]
10 Service de neurologie [CHRU Nancy]
11 CIC 0004 - Nantes - Centre d'investigation clinique (CIC) de Nantes -CIC Plurithématique
12 Service de Neurologie [CHU Nice]
13 CIC 1402 - CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
14 Service de neurologie [CHU de Poitiers]
15 Service de Neurologie [Strasbourg]
16 Service de neurochirurgie [CHU Dijon]
17 EpiMaCT - Epidémiologie des Maladies Chroniques en zone tropicale
18 Service de Neurologie [CHU Limoges]
19 CHU Montpellier = Montpellier University Hospital
20 Pôle NIRR - Service de Neurologie [CHU Nimes]
21 Service de neurologie [Reims]
22 CIC - Centre d'Investigation Clinique [Rennes]
23 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
24 Service de neurologie [Rouen]
25 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
26 PEPITES - Pharmacoépidémiologie et évaluation des soins [iPLesp]
Solène Frismand
David Maltête

Résumé

Background: Postural abnormalities (PA) and motor complications (MCs, including motor fluctuations - MFs- and levodopa-induced dyskinesia - LIDs) are hallmark of Parkinson's disease (PD) progression, yet their relationship remains poorly understood.
Objective: To investigate the association between PA and MCs, motor symptoms, and non-motor symptoms (NMS) in patients with PD, and to assess whether PA influences the development of MCs over time.
Methods: Data of the prospective NS-Park cohort (27 French PD Expert Centers) were analysed. PA was defined by a score ≥2 on item 3.13 of the MDS-UPDRS-III. Associations between PA and MCs, as well as with other motor symptoms and NMS, were assessed using logistic regression models. We used interval censoring survival models to assess the associations between PA at inclusion and the incidence of MCs. Analyses were adjusted for sex, age, disease duration, dopaminergic dose, and disease severity.
Results: Among 13,037 included PD patients (58.7 % male, median age at diagnosis 61 years), 724 (5.6 %) presented with PA. Patients with PA had longer disease duration, higher disease severity, and higher dopaminergic treatment. PA exhibited a higher prevalence of troublesome MFs (OR: 5.96; 95 % CI: 4.25-8.32) and LIDs (OR: 2.81; 95 % CI: 1.79-4.30), while associations with milder MCs were inconsistent. However, PA was not significantly associated with the development of MCs during follow-up.
Conclusions: PA are associated with more frequent severe MCs, and a higher burden of motor and NMS, making patient care particularly challenging.

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Dates et versions

hal-05391244 , version 1 (27-01-2026)

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Margherita Fabbri, Aymeric Lanore, Nathalie Bertille, Jean-Christophe Corvol, Olivier Rascol, et al.. Motor complications and postural abnormalities interplay in Parkinson's disease. Parkinsonism & Related Disorders, 2026, 142, pp.108124. ⟨10.1016/j.parkreldis.2025.108124⟩. ⟨hal-05391244⟩
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