Mascia Marcello Mario, Belvisi Daniele, Esposito Marcello, Pellicciari Roberta, Trinchillo Assunta, Terranova Carmen, Bertino Salvatore, Avanzino Laura, Di Biasio Francesca, Bono Francesco, Laterza Vincenzo, Lettieri Christian, Eleopra Roberto, Fabbrini Giovanni, Barbero Pierangelo, Bertolasi Laura, Altavista Maria Concetta, Erro Roberto, Ceravolo Roberto, Castagna Anna, Zibetti Maurizio, Bentivoglio Anna Rita, Cossu Giovanni, Magistrelli Luca, Scaglione Cesa, Albanese Alberto, Cotelli Maria Sofia, Misceo Salvatore, Pisani Antonio, Schirinzi Tommaso, Maderna Luca, Squintani Giovanna, Berardelli Alfredo, Defazio Giovanni
Neurology Unit, University Hospital of Cagliari, Cagliari, Italy.
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy.
Parkinsonism Relat Disord. 2023 Oct;115:105851. doi: 10.1016/j.parkreldis.2023.105851. Epub 2023 Sep 12.
Although acquired dystonia may develop following ischaemic/haemorrhagic stroke, the relationship between cerebrovascular disease and idiopathic dystonia has been poorly investigated. This cross sectional study aimed at evaluating the impact of cerebrovascular risk factors on the clinical expression of idiopathic adult onset dystonia (IAOD), with reference to dystonia localization and dystonia-associated features.
Data were obtained from the Italian Dystonia Registry. Patients with IAOD were stratified into two groups according to the presence of diabetes mellitus and/or arterial hypertension and/or dyslipidemia and/or heart disease. The two groups were compared for demographic features, dystonia phenotype, and dystonia-associated features (sensory trick, tremor, eye symptoms in blepharospasm, and neck pain in cervical dystonia).
A total of 1108 patients participated into the study. Patients who reported one cerebrovascular factor or more (n = 555) had higher age and longer disease duration than patients who did not. On multivariable logistic regression analysis, blepharospasm was the only localization, and sensory trick was the only dystonia-associated feature that was significantly associated with cerebrovascular risk factors. Linear regression analysis showed that the strength of the association between cerebrovascular factors and blepharospasm/sensory trick increased with increasing the number of cerebrovascular factors per patient.
Results of the present study showed that cerebrovascular risk factors may be associated with specific features of IAOD that is development of blepharospasm and sensory trick. Further studies are needed to better understand the meaning and the mechanisms underlying this association.
尽管后天性肌张力障碍可能在缺血性/出血性中风后发生，但脑血管疾病与特发性肌张力障碍之间的关系尚未得到充分研究。这项横断面研究旨在评估脑血管危险因素对特发性成人起病肌张力障碍（IAOD）临床表型的影响，同时参考肌张力障碍的定位和与肌张力障碍相关的特征。
数据来自意大利肌张力障碍登记处。根据是否存在糖尿病和/或动脉高血压和/或血脂异常和/或心脏病，将IAOD患者分为两组。比较两组的人口统计学特征、肌张力障碍表型和与肌张力障碍相关的特征（感觉技巧、震颤、眼睑痉挛中的眼部症状以及颈部肌张力障碍中的颈部疼痛）。
共有1108名患者参与了这项研究。报告有一个或多个脑血管因素的患者（n = 555）比没有这些因素的患者年龄更大，病程更长。在多变量逻辑回归分析中，眼睑痉挛是唯一与脑血管危险因素显著相关的定位，感觉技巧是唯一与肌张力障碍相关的特征。线性回归分析表明，脑血管因素与眼睑痉挛/感觉技巧之间的关联强度随着每位患者脑血管因素数量的增加而增加。
本研究结果表明，脑血管危险因素可能与IAOD的特定特征相关，即眼睑痉挛和感觉技巧的出现。需要进一步研究以更好地理解这种关联的意义和潜在机制。
