Our key aspects of research are the development of clinical and radiological diagnostic criteria as well as the evaluation of different additional technical examinations (muscle MRI, muscle biopsy, EMG) and the exploration of pathophysiology, which could lead to effective therapies.
Work is in progress to define a clinical rating scale for (semi-)quantitative characterization of camptocormia. After creating a pre-version and its evaluation on a local stage, we aim to refine and establish it with help from our international colleagues and the Movement Disorder Society. The assessment of the severity of camptocormia might be a relevant outcome parameter for therapeutic studies to come.
In a cross-sectional study we showed that pathological changes in the dorsal trunk muscles of camptocormia patients mainly depends on the duration of camptocormia. Swelling and edema of the paravertebral muscles were labeled as acute changes in patients with a shorter duration of camptocormia. A progressive fatty degeneration was described as chronic and found in patients, who suffered for a longer period from camptocormia (see Figure). Properly this model is of great importance for therapeutic approaches. We further evaluate this hypothesis in a follow-up study. Additionally we include other dorsal trunk muscles in our analysis.
A study using surface-EMG showed a hyperactivity of the paravertebral muscles compared to controls. The necessary use of the functional reserve of these muscles while standing was interpreted as weakness. In an additional study we directly examine force recordings of the trunk muscles. Furthermore we include leg and hip muscles to receive a systematic understanding of the interacting muscle system. These data might also help to understand MRI muscle findings and to differentiate dystonic from myopathic mechanisms.