Psychomotor disadaptation syndrome

Abstract

Psychomotor disadaptation syndrome (PDS) was first described by The Dijon School of Geriatry (France) 30 years ago, and named “psychomotor regression syndrome”. The initial clinical description has not changed. However, progress has been made in both the understanding of its physiopathology and in its management, hence the change in its name to PDS in the late 1990s. Since the early 2000s, another name, frontal-sub-cortical dysfunction syndrome, has been used to designate this entity. PDS is the decompensation of postural function, gait and psychomotor automatisms linked to the impairment of posture and motor programming. This impairment is due to frontal-sub-cortical lesions. PDS is characterized by retropulsion, non-specific gait disorders, neurological signs (including akinesia, reactional hypertonia, and impaired reactive postural responses and protective reactions) and psychological disturbances (fear of standing and walking as an acute feature or slowness of cognitive processing and anhedonia as a chronic feature). The occurrence of PDS is linked to the combination of three factors implicated in the decrease in functional reserves due to the deterioration of frontal-sub-cortical structures: ageing, chronic affections (mainly degenerative or vascular), and acute organic or functional factors which induce a reduction in cerebral blood flow. Multidisciplinary management, including medical, motor physiotherapy and psychological approaches, is indispensable for PDS.