Qiyu Chen1, Jeanne P Vu1, Elizabeth Cisneros1, Casey N Benadof1, Zheng Zhang1, Richard L Barbano2, Christopher G Goetz3, Joseph Jankovic4, Hyder A Jinnah5, Joel S Perlmutter6,7, Mark I Appelbaum8, Glenn T Stebbins3, Cynthia L Comella3, David A Peterson1,9. 1. Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA. 2. Department of Neurology, University of Rochester, Rochester, NY, USA. 3. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA. 4. Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA. 5. Departments of Neurology and Human Genetics, Emory University, Atlanta, GA, USA. 6. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. 7. Departments of Psychiatry, Radiology, Neurobiology, Physical Therapy, and Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. 8. Department of Psychology, University of California, San Diego, La Jolla, CA, USA. 9. Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, USA.
Abstract
Background: Although abnormal head and neck postures are defining features of cervical dystonia (CD), head tremor (HT) is also common. However, little is known about the relationship between abnormal postures and HT in CD. Methods: We analyzed clinical data and video recordings from 185 patients enrolled by the Dystonia Coalition. We calculated the likelihood of their HT and HT type ("regular" vs. "jerky") given directionality of abnormal head postures, disease duration, sex, and age. Results: Patients with retrocollis were more likely to have HT than patients with anterocollis (X2 (1, N = 121) = 7.98, p = 0.005). There was no difference in HT likelihood given left or right turning in laterocollis and rotation. Patients with HT had longer disease duration (t(183) = 2.27, p = 0.024). There was no difference in age between patients with and without HT. In a logistic regression model, anterocollis/retrocollis direction (X2 (1, N = 121) = 6.04, p = 0.014), disease duration (X2 (1, N = 121) = 7.28, p = 0.007), and the interaction term between age and disease duration (X2 (1, N = 121) = 7.77, p = 0.005) collectively contributed to HT likelihood. None of the postural directionality or demographic variables were associated with differential likelihood of having regular versus jerky HT. Discussion: We found that HT is more likely for CD patients with a specific directionality in their predominant posture. Our finding that CD patients with longer disease duration have a higher likelihood of HT also raises the question of whether HT becomes more likely over time in individual patients.
Background: Although abnormal head and neck postures are defining features of cervical dystonia (CD), head tremor (HT) is also common. However, little is known about the relationship between abnormal postures and HT in CD. Methods: We analyzed clinical data and video recordings from 185 patients enrolled by the Dystonia Coalition. We calculated the likelihood of their HT and HT type ("regular" vs. "jerky") given directionality of abnormal head postures, disease duration, sex, and age. Results:Patients with retrocollis were more likely to have HT than patients with anterocollis (X2 (1, N = 121) = 7.98, p = 0.005). There was no difference in HT likelihood given left or right turning in laterocollis and rotation. Patients with HT had longer disease duration (t(183) = 2.27, p = 0.024). There was no difference in age between patients with and without HT. In a logistic regression model, anterocollis/retrocollis direction (X2 (1, N = 121) = 6.04, p = 0.014), disease duration (X2 (1, N = 121) = 7.28, p = 0.007), and the interaction term between age and disease duration (X2 (1, N = 121) = 7.77, p = 0.005) collectively contributed to HT likelihood. None of the postural directionality or demographic variables were associated with differential likelihood of having regular versus jerky HT. Discussion: We found that HT is more likely for CDpatients with a specific directionality in their predominant posture. Our finding that CDpatients with longer disease duration have a higher likelihood of HT also raises the question of whether HT becomes more likely over time in individual patients.
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