Sternocleidomastoid Muscle Overactivity: A Potentially Critical Contributor to Postural Abnormalities in Parkinson's Disease
Sha Zhu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
These authors contributed equally to this work.
Search for more papers by this authorRonghua Hong MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
These authors contributed equally to this work.
Search for more papers by this authorZhuang Wu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorYunjun Bao MM
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorYunping Song PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorGuojiong Hu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorZhongfei Bai PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorFeifei Zhu MSc
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorZhenhua Liao BSc
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorLizhen Pan MD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorQiang Guan PhD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorCorresponding Author
Zhuoyu Zhang PhD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Address correspondence to Dr Zhuoyu Zhang, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Neurological Department of Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, China. E-mail: [email protected] Prof Lingjing Jin, Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, 2209 Guangxing Road, Shanghai 201619, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Lingjing Jin PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China
Address correspondence to Dr Zhuoyu Zhang, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Neurological Department of Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, China. E-mail: [email protected] Prof Lingjing Jin, Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, 2209 Guangxing Road, Shanghai 201619, China. E-mail: [email protected]
Search for more papers by this authorSha Zhu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
These authors contributed equally to this work.
Search for more papers by this authorRonghua Hong MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
These authors contributed equally to this work.
Search for more papers by this authorZhuang Wu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorYunjun Bao MM
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorYunping Song PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorGuojiong Hu MD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorZhongfei Bai PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorFeifei Zhu MSc
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorZhenhua Liao BSc
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorLizhen Pan MD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorQiang Guan PhD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Search for more papers by this authorCorresponding Author
Zhuoyu Zhang PhD
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Address correspondence to Dr Zhuoyu Zhang, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Neurological Department of Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, China. E-mail: [email protected] Prof Lingjing Jin, Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, 2209 Guangxing Road, Shanghai 201619, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Lingjing Jin PhD
Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China
Address correspondence to Dr Zhuoyu Zhang, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Neurological Department of Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, China. E-mail: [email protected] Prof Lingjing Jin, Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, 2209 Guangxing Road, Shanghai 201619, China. E-mail: [email protected]
Search for more papers by this authorAbstract
Objective
Overactivity of muscles is thought to be involved in postural abnormalities (PA) in Parkinson's disease (PD). Here, we investigated the relationship between muscle activity and postural parameters to explore the peripheral mechanisms of PA.
Methods
A total of 90 PD patients and 19 healthy controls were enrolled. Posture features (F1–F8) and the index for PA were collected. Surface electromyography was acquired from cervical and thoracolumbar muscles during lying, sitting, standing, and walking, respectively. Follow-up was completed for a subset of PD patients.
Results
Root mean square (RMS) amplitudes of the sternocleidomastoid muscle (SCM) and external oblique muscle, were higher in PD patients with PA (PD_PA) than PD patients without PA (PD_NPA) and healthy controls during lying and standing. Extensor activity in PD_PA patients increased only in the antigravity position compared with PD_NPA patients. Spearman's correlation showed that RMS amplitude of SCM in the lying position was associated with index for PA and forward flexion angles including F3–F8, whereas RMS amplitude of the external oblique muscle in the lying position was correlated with F5 alone. Longitudinal analysis showed that changes in F3, F4, and index for PA were significantly correlated with changes in RMS amplitude of the SCM in the lying position. Additionally, PD_NPA patients with SCM overactivity had a significantly higher risk of progressing to PA than those with normal SCM activity.
Interpretation
The SCM and external oblique muscle are involved in forward trunk flexion in PD patients, while extensors may play a compensatory role. SCM may be the key muscle in PA for PD patients, participating in the pathogenesis of PA. ANN NEUROL 2025
Potential Conflicts of Interest
Nothing to report.
Open Research
Data Availability
The data supporting the findings of this study are available on request from the corresponding author.
Supporting Information
| Filename | Description |
|---|---|
| ana27310-sup-0001-Supinfo.docxWord 2007 document , 600.8 KB | Figure S1. Illustration of the eight selected features. (A) F1: lateral flexion angle of head; (B) F2: lateral flexion angle of trunk; (C) F3: forward flexion angle of head; (D) F4: total forward flexion angle of trunk; (E) F5: forward flexion angle of trunk at the waist; (F) F6: forward flexion angle of trunk at the thorax; (G) F7: distance between the most convex point of the back and the trunk axis; (H) F8: forward flexion angle of head relative to trunk. Figure S2. Paired Comparison of muscle activation between anti-gravity and lying position. Figure S3. Comparison of sEMG of bilateral trunk in PD-LTF patients. Table S1. Detailed EMG findings of PD-LTF patient in the standing position. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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