Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Medical Specialists of the Palm Beaches Neurology, Inc., Atlantis, FL, USA.
Parkinsonism Relat Disord. 2024 Oct;127:107114. doi: 10.1016/j.parkreldis.2024.107114. Epub 2024 Aug 23.
To study the prevalence and clinical features of cervical dystonia in Parkinson's disease (CD-PD).
PD features various forms of dystonia, including CD. Yet, the prevalence and clinical features of CD in PD patients are not well-characterized.
We conducted a single site, prospective study where consecutively evaluated PD patients were examined for the presence of CD to ascertain its prevalence. For each case of CD-PD, a standardized questionnaire assessing demographic and clinical features was completed. Statistical analysis was performed to compare CD-PD characteristics to those of a previously published large idiopathic CD cohort.
Of 301 consecutive PD patients evaluated, 28 (9.3 %) had CD, far surpassing estimates of CD prevalence in the general population. This CD-PD cohort was predominantly male (71 %) with a mean age of 70.9 ± 8.1 years. The mean duration of PD was 10.4 ± 6.7 years. In most cases (n = 19, 68 %), CD developed after the onset of PD. Five patients reported dystonia improvements in response to levodopa, while none reported medication-induced worsening. In contrast to CD-PD, those with ICD (n = 209) were on average younger (59.7 ± 10.1) and mostly female (74 %, p < 0.001). In addition, CD-PD was overall less severe as measured by the Global Dystonia Rating Scale (GDRS) (p = 0.002) and featured less head tremor and pain.
Our findings indicate CD is overrepresented in PD compared to the general population and has clinical features distinct from those of ICD. These results justify larger, more comprehensive studies of CD-PD to better understand its frequency, pathophysiology, clinical characteristics, and associated risk factors.
研究帕金森病（PD）中颈肌张力障碍（CD）的患病率和临床特征。
PD 表现出多种形式的肌张力障碍，包括 CD。然而，PD 患者 CD 的患病率和临床特征尚未得到很好的描述。
我们进行了一项单站点前瞻性研究，对连续评估的 PD 患者进行 CD 检查，以确定其患病率。对于每例 CD-PD，都完成了一份评估人口统计学和临床特征的标准化问卷。进行了统计学分析，以比较 CD-PD 特征与先前发表的大型特发性 CD 队列的特征。
在评估的 301 例连续 PD 患者中，28 例（9.3%）患有 CD，远远超过一般人群中 CD 的患病率估计值。该 CD-PD 队列主要为男性（71%），平均年龄为 70.9±8.1 岁。PD 的平均病程为 10.4±6.7 年。在大多数情况下（n=19，68%），CD 在 PD 发病后出现。5 例患者报告在服用左旋多巴后出现了改善，而没有报告药物引起的恶化。与 CD-PD 相比，ICD 患者（n=209）的平均年龄更小（59.7±10.1），且大多为女性（74%，p<0.001）。此外，CD-PD 的整体严重程度较低，以全球肌张力障碍评定量表（GDRS）衡量（p=0.002），且较少出现头部震颤和疼痛。
我们的发现表明，与一般人群相比，CD 在 PD 中更为常见，且具有与 ICD 不同的临床特征。这些结果证明了需要进行更大、更全面的 CD-PD 研究，以更好地了解其频率、病理生理学、临床特征和相关的危险因素。
