Institute for Neural Computation, University of California, La Jolla, San Diego, CA, USA.
Department of Neurology, University of Rochester, Rochester, NY, USA.
J Neurol. 2021 May;268(5):1945-1950. doi: 10.1007/s00415-020-10378-5. Epub 2021 Jan 8.
Although head tremor (HT) and pain are prevalent in cervical dystonia (CD), their joint relationship to phenotypic features of focal dystonia remains unclear.
We examined how severity of HT and pain are associated with age of CD onset and duration, and whether HT subtypes ("jerky" or "regular") exhibit distinct relationships between severity of HT and pain.
The severity of HT and pain were assessed with the Toronto Western Spasmodic Torticollis Rating Scale in retrospective review of 188 CD patients recruited through the Dystonia Coalition.
HT severity was associated with longer CD duration (p < 0.0005), whereas pain severity was associated with younger age at onset (p = 0.043). HT severity and pain severity were not correlated for jerky HT (p = 0.996), but positively correlated for regular HT (p = 0.01).
The distinct associations of HT and pain with age at onset, disease duration, and HT subtype further characterize the heterogeneity of CD's clinical presentation and suggest similarly heterogeneous underlying mechanisms.
尽管头部震颤（HT）和疼痛在颈性肌张力障碍（CD）中很常见，但它们与局灶性肌张力障碍的表型特征之间的联合关系仍不清楚。
我们研究了 HT 和疼痛的严重程度与 CD 发病年龄和病程的关系，以及 HT 亚型（“顿挫型”或“规则型”）是否在 HT 严重程度与疼痛之间存在不同的关系。
通过对通过肌张力障碍联盟招募的 188 例 CD 患者的回顾性研究，使用多伦多西部痉挛性斜颈严重程度评分量表评估 HT 和疼痛的严重程度。
HT 严重程度与 CD 病程较长相关（p<0.0005），而疼痛严重程度与发病年龄较小相关（p=0.043）。顿挫型 HT 的 HT 严重程度和疼痛严重程度之间没有相关性（p=0.996），而规则型 HT 的 HT 严重程度和疼痛严重程度之间呈正相关（p=0.01）。
HT 和疼痛与发病年龄、病程以及 HT 亚型的不同关联进一步描述了 CD 临床表现的异质性，并提示存在类似的异质性潜在机制。
