Objective: To perform a prospective analysis of the prevalence and clinical characteristics of cervical dystonia in Parkinson’s disease (CD-PD) and compare these features to those of idiopathic isolated CD (ICD).

Background: It is well known that PD features various forms of dystonia. While certain syndromes (e.g., foot dystonia) have been well described, the prevalence and characteristics of CD in PD patients is not well-characterized.

Method: This is a single site, prospective study in which 13 movement disorder practitioners evaluated every PD patient seen in clinic for the presence of CD over the course of one month. If CD was present, a standardized assessment was completed. Clinical features in those with CD-PD were compared to a cohort of 209 ICD patients from the Dystonia Coalition (1).  Analyses utilized chi-square for categorical variables and t-tests for continuous variables.

Results: Of 301 consecutive PD patients evaluated in clinic, 28 (9.3%) had CD. The mean age of those with CD-PD was 70.9±8.1 years. The mean duration of PD was 10.4±6.7 years, and CD was present prior to PD in only 4 patients (14%, range 1.5-50 years).  The CD-PD group was predominantly male (71%), while those with ICD were mostly female (74%, p<0.001). ICD patients were more likely to have associated tremor and pain compared to those with CD-PD (p<0.001). The average severity as measured by the Global Dystonia Rating Scale was 5.55±2.29 among those with ICD compared to 4.14±1.94 among CD-PD cases (p=0.002).  The distribution of dystonia beyond the cervical region was similar in both groups. Levodopa did not tend to worsen CD-PD and improved dystonia symptoms in 4 cases (18%).

Conclusion: CD was more common in PD than in the general population (2). Most patients with CD-PD developed dystonia after the onset of PD. CD development did not appear to be caused by levodopa therapy. Clinical differences between PD-CD and ICD may reflect differences in pathophysiology.

References: 1. Comella CL et al. Clinimetric testing of the comprehensive cervical dystonia rating scale. Mov Disord. 2016; 31(4): 563–569.
2. Defazio G et al. Descriptive epidemiology of cervical dystonia. Tremor Other Hyperkinet Mov 2013; 3:tre-03-193-4374-2.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-comparison-of-cervical-dystonia-in-parkinsons-disease-and-idiopathic-isolated-cervical-dystonia/