The natural course of idiopathic cervical dystonia

被引:0
作者
Dirk Dressler
Bruno Kopp
Lizhen Pan
Fereshte Adib Saberi
机构
[1] Hannover Medical School,Movement Disorders Section, Department of Neurology
[2] Hannover Medical School,Department of Neurology
[3] Neurotoxin Research Center,Department of Neurology
[4] Tongji University School of Medicine,undefined
[5] IAB-Interdisciplinary Working Group for Movement Disorders,undefined
来源
Journal of Neural Transmission | 2024年 / 131卷
关键词
Idiopathic cervical dystonia; Natural course; Type 1; Type 2; Excessive psychological stress;
D O I
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中图分类号
学科分类号
摘要
Idiopathic cervical dystonia (ICD) is by far the largest subgroup of dystonia. Still, its natural course is largely unknown. We studied the natural course of 100 ICD patients from our botulinum toxin clinics (age at ICD onset 45.8 ± 13.5 years, female/male ratio 2.0) over a period of 17.5 ± 11.5 years with follow-ups during botulinum toxin therapy and with semi-structured interviews. Two courses of ICD could be distinguished by symptom development of more or less than 6 months. ICD-type 2 was less frequent (19% vs 81%, p < 0.001), had a more rapid onset (8.7 ± 8.0 weeks vs 3.8 ± 3.5 years), a higher remission rate (92% vs 5%, p < 0.001) and a higher prevalence of excessive psychological stress preceding ICD (63% vs 1%, p < 0.001). In both ICD-types, the plateau phase was non-progressive. Significant differences in patient age at ICD onset, latency and extent of remission, female/male ratio and prevalence of family history of dystonia could not be detected. ICD is a non-progressive disorder. ICD-type 1 represents the standard course. ICD-type 2 features rapid onset, preceding excessive psychological stress and a high remission rate. These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms. They contradict the widespread fear of patients of a constant and continued decline of their condition. Excessive psychological stress may be an epigenetic factor triggering the manifestation of genetically predetermined dystonia.
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页码:245 / 252
页数:7
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