POSTURAL STABILITY DIFFERENTIATES LOWER-BODY FROM IDIOPATHIC PARKINSONISM

Introduction - Patients with an akinetic Parkinson syndrome of the Low er extremities and a poor response to L-DOPA have been described as '' lower body Parkinsonism'' (LBP). These patients are characterized by f requent failings and poor balance. Methods - We have studied body sway with static (force platform) and dynamic (Equitest) posturography in 11 LBP patients, 6 of them revealing deep white matter lesions on MRI and 10 patients with advanced Parkinson's disease (PD) and compared pe rformance with 30 age-matched controls. Results - When standing on a f ixed support the postural performance of both patient groups lay withi n the normal range. The balance of LBP patients worsened in the static testing in the conditions ''eyes open on foam'' (p < 0.05) and ''eyes closed on foam'' (p < 0.0006, of 11 patients falling), whereas the ba lance of PD patients deteriorated only with ''eyes closed on foam'' (p < 0.05). Dynamic posturography confirmed these results in 6 different sensory conditions, clearly distinguishing the more unstable LBP pati ents from PD patients during ''standing, eyes closed, foot support swa y referenced'' (p < 0.005). Conclusion - We conclude, that postural ad justments in LBP patients are more disturbed than those in PD patients and posturography can be an additional tool for the differential diag nosis of Parkinson syndromes with gait disorders.