Defazio G, Berardelli A, Abbruzzese G, Lepore V, Coviello V, Acquistapace D, Capus L, Carella F, De Berardinis M T, Galardi G, Girlanda P, Maurri S, Albanese A, Bertolasi L, Liguori R, Rossi A, Santoro L, Tognoni G, Livrea P
Institute of Neurology, University of Bari, Italy.
J Neurol Neurosurg Psychiatry. 1998 Jan;64(1):25-32. doi: 10.1136/jnnp.64.1.25.
Little is known about the aetiology of idiopathic adult onset dystonia. The Italian Movement Disorders Study Group promoted a case-control study on some hypothetical risk factors including past medical events, life events, life habits, occupational hazards, and family history of dystonia, parkinsonism, and tremor.
Cases affected by idiopathic adult onset dystonia (age at symptom onset >20 years, duration of disease >one year and <five years) were selected among consecutive outpatients attending 14 Italian centres. Control outpatients matched for age (+/-5 years), sex, and referral centre were identified among diagnostic categories thought to be unassociated with study exposures. Information was obtained by a standardised questionnaire administered by medical interviewers. Conditional logistic univariate and multivariate regression analyses were performed by a standard statistical package.
Multivariate analysis on 202 cases and 202 age and sex matched control outpatients indicated that head or facial trauma with loss of consciousness, family history of dystonia, and family history of postural tremor independently increased the risk of developing adult onset dystonia, whereas hypertension and cigarette smoking exerted a protective effect. The findings also suggested a positive association between local body injury-for example, previous ocular diseases and neck or trunk trauma-and dystonia of the same body part.
The results support the idea that environmental and genetic factors may both be important in the aetiology of adult onset dystonia, and suggest aetiological clues worthy of further analytical investigation.
关于特发性成人起病肌张力障碍的病因，人们知之甚少。意大利运动障碍研究小组开展了一项病例对照研究，涉及一些假设的风险因素，包括既往病史、生活事件、生活习惯、职业危害以及肌张力障碍、帕金森病和震颤的家族史。
在14个意大利中心的连续门诊患者中，选取特发性成人起病肌张力障碍患者（症状出现时年龄>20岁，病程>1年且<5年）。在被认为与研究暴露无关的诊断类别中，确定年龄（±5岁）、性别和转诊中心匹配的对照门诊患者。信息通过由医学访谈员管理的标准化问卷获得。使用标准统计软件包进行条件逻辑单变量和多变量回归分析。
对202例患者和202例年龄及性别匹配的对照门诊患者进行多变量分析表明，伴有意识丧失的头部或面部创伤、肌张力障碍家族史和姿势性震颤家族史独立增加成人起病肌张力障碍的发病风险，而高血压和吸烟则具有保护作用。研究结果还表明，局部身体损伤（例如既往眼部疾病以及颈部或躯干创伤）与同一身体部位的肌张力障碍之间存在正相关。
结果支持环境和遗传因素在成人起病肌张力障碍病因中可能都很重要的观点，并提示了值得进一步分析研究的病因线索。
