Giovanni Defazio1, Giovanni Fabbrini2, Roberto Erro3, Alberto Albanese4, Paolo Barone3, Maurizio Zibetti5, Marcello Esposito6, Roberta Pellicciari7, Laura Avanzino8, Francesco Bono9, Roberto Eleopra10, Laura Bertolasi11, Maria Concetta Altavista12, Maria Sofia Cotelli13, Roberto Ceravolo14, Cesa Scaglione15, Anna Rita Bentivoglio16, Giovanni Cossu17, Mario Coletti Moja18, Paolo Girlanda19, Salvatore Misceo20, Antonio Pisani21, Marcello Mario Mascia1, Tommaso Ercoli22, Michele Tinazzi23, Luca Maderna24, Brigida Minafra25, Luca Magistrelli26, Marcello Romano27, Marco Aguggia28, Nicola Tambasco29, Anna Castagna30, Daniela Cassano31, Alfredo Berardelli2. 1. Department of Medical Science and Public Health, Institute of Neurology, University of Cagliari, Italy. 2. IRCCS, Neuromed, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy. 3. Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, (SA), Italy. 4. Department of Neurology, IRCCS, Istituto Clinico Humanitas, Rozzano, Milan, Italy. 5. Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Turin, Italy. 6. Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy. 7. Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy. 8. Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Italy. 9. Center for Botulinum Toxin Therapy, Neurologic Unit, A.O.U. Mater domini, Catanzaro, Italy. 10. Neurological Unit 1, Fondazione IRCSS, Istituto Neurologico "Carlo Besta", Milan, Italy. 11. Neurologic Unit, University Hospital, Verona, Italy. 12. Neurology Unit, San Filippo Neri Hospital ASL Roma 1, Roma, Italy. 13. Neurology Unit, ASST Valcamonica, Esine, Italy. 14. Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Italy. 15. IRCCS Institute of Neurological Sciences, Bologna, Italy. 16. Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy. 17. Neurology Service and Stroke Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy. 18. Neurology Unit, Umberto I Hospital, Turin, Italy. 19. Department of Clinical and Experimental Medicine, University of Messina, Italy. 20. Neurologic Unit, San Paolo Hospital, Bari, Italy. 21. Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. 22. Department of Medical Science and Public Health, Institute of Neurology, University of Cagliari, Italy. Electronic address: ercolitommaso@me.com. 23. Dipartimento Di Neuroscienze, Biomedicina e Movimento, Università di Verona, Italy. 24. Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milan, Italy. 25. Parkinson's Disease and Movement Disorders Unit, IRCCS, Mondino Foundation, Pavia, Italy. 26. Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; PhD programe in clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, Italy. 27. Neurology Unit, AOOR Villa Sofia Cervello, Palermo, Italy. 28. Neurology Department, Asti Hospital, Asti, Italy. 29. Neurology Department, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. 30. IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy. 31. Unit of Neurology, Ospedale Maria Vittoria, Turin, Italy.
Abstract
BACKGROUND: Acute peripheral trauma is a controversial risk factor for idiopathic dystonia. MATERIALS AND METHODS: We retrospectively analyzed data from the Italian Dystonia Registry regarding the occurrence of acute peripheral trauma severe enough to require medical attention in 1382 patients with adult-onset idiopathic dystonia and 200 patients with acquired adult-onset dystonia. RESULTS: Patients with idiopathic and acquired dystonia showed a similar burden of peripheral trauma in terms of the number of patients who experienced trauma (115/1382 vs. 12/200, p = 0.3) and the overall number of injuries (145 for the 1382 idiopathic patients and 14 for the 200 patients with secondary dystonia, p = 0.2). Most traumas occurred before the onset of idiopathic or secondary dystonia but only a minority of such injuries (14 in the idiopathic group, 2 in the acquired group, p = 0.6) affected the same body part as that affected by dystonia. In the idiopathic group, the elapsed time between trauma and dystonia onset was 8.1 ± 9.2 years; only six of the 145 traumas (4.1%) experienced by 5/1382 idiopathic patients (0.36%) occurred one year or less before dystonia onset; in the acquired dystonia group, the two patients experienced prior trauma to the dystonic body part 5 and 6 years before dystonia development. DISCUSSION AND CONCLUSION: Our data suggest that the contribution of peripheral acute trauma to idiopathic dystonia is negligible, if anything, and likely involves only a small subset of patients.
BACKGROUND: Acute peripheral trauma is a controversial risk factor for idiopathic dystonia. MATERIALS AND METHODS: We retrospectively analyzed data from the Italian Dystonia Registry regarding the occurrence of acute peripheral trauma severe enough to require medical attention in 1382 patients with adult-onset idiopathic dystonia and 200 patients with acquired adult-onset dystonia. RESULTS:Patients with idiopathic and acquired dystonia showed a similar burden of peripheral trauma in terms of the number of patients who experienced trauma (115/1382 vs. 12/200, p = 0.3) and the overall number of injuries (145 for the 1382 idiopathic patients and 14 for the 200 patients with secondary dystonia, p = 0.2). Most traumas occurred before the onset of idiopathic or secondary dystonia but only a minority of such injuries (14 in the idiopathic group, 2 in the acquired group, p = 0.6) affected the same body part as that affected by dystonia. In the idiopathic group, the elapsed time between trauma and dystonia onset was 8.1 ± 9.2 years; only six of the 145 traumas (4.1%) experienced by 5/1382 idiopathic patients (0.36%) occurred one year or less before dystonia onset; in the acquired dystonia group, the two patients experienced prior trauma to the dystonic body part 5 and 6 years before dystonia development. DISCUSSION AND CONCLUSION: Our data suggest that the contribution of peripheral acute trauma to idiopathic dystonia is negligible, if anything, and likely involves only a small subset of patients.
Authors: Tommaso Ercoli; Giovanni Defazio; Christian Geroin; Enrico Marcuzzo; Giovanni Fabbrini; Francesco Bono; Alessandro Mechelli; Roberto Ceravolo; Luigi Michele Romito; Alberto Albanese; Antonio Pisani; Maurizio Zibetti; Maria Concetta Altavista; Luca Maderna; Martina Petracca; Paolo Girlanda; Marcello Mario Mascia; Alfredo Berardelli; Michele Tinazzi Journal: Mov Disord Clin Pract Date: 2021-09-10