Psychomotor disadaptation syndrome

Psychomotor disadaptation syndrome (PDS) was first described in France by the Dijon geriatric school, 25 years ago, and named ``psychomotor regression syndrome''. The initial clinical description still remains without modifications. However, progress has been made both in understanding its physiopathology and management, and its name has been changed into PDS in the late 1990s. Since the early 2000s, it was also termed frontal-sub-cortical dysfunction syndrome. PDS results from decompensation of postural function, gait and psychomotor automatisms linked to posture and motor programming impairment related to fronto-sub-cortical lesions. PDS is characterized by retropulsion, nonspecific gait disorders, neurological signs (including akinesia, reactional hypertonia, and impaired reactive postural responses and protective reactions) and psychological disorders (fear of standing and walking as an acute feature or cognitive processing retardation and anhedonia as a chronic feature). PDS occurrence is linked to three factors implicated in functional reserve impairment due to frontal-sub-cortical structures disturbances: aging, chronic affections (mainly of degenerative or vascular origin), and acute organic or functional factors which induce cerebral blood flow decrease. Multidisciplinary management, including medical motor physiotherapy and psychological approach, is required for patients with PDS care.