Assessing the Severity of Cervical Dystonia: Ask the Doctor or Ask the Patient?

Adam C. Cotton, Laura Scorr, William McDonald, Cynthia Comella, Joel S. Perlmutter, Christopher G. Goetz, Joseph Jankovic, Laura Marsh, Stewart Factor, H. A. Jinnah

Research output: Contribution to journalArticlepeer-review


Background: Assessing disease severity can be performed using either clinician-rated scales (CRS) or patient-rated outcome (PRO) tools. These two measures frequently demonstrate poor correlations. Objectives: To determine if the correlation between a CRS and PRO for motor features of cervical dystonia (CD) improves by accounting for non-motor features. Methods: Subjects with CD (N = 209) were evaluated using a CRS (Toronto Western Spasmodic Torticollis Rating Scale, TWSTRS) and a PRO (Cervical Dystonia Impact Profile, CDIP-58). Results: Linear regression revealed a weak correlation between the two measures, even when considering only the motor subscales of each. The strength of this relationship improved with a regression model that included non-motor symptoms of pain, depression, and disability. Conclusions: These results argue that the results of motor assessments in a PRO for CD cannot be fully appreciated without simultaneous assessment of non-motor co-morbidities. This conclusion might apply to other disorders, especially those with frequent non-motor co-morbidities.

Original languageEnglish
Pages (from-to)1399-1403
Number of pages5
JournalMovement Disorders Clinical Practice
Issue number9
StatePublished - Sep 2023


  • anxiety
  • cervical dystonia
  • depression
  • dystonia
  • patient-reported outcome measure
  • rating scale
  • torticollis


Dive into the research topics of 'Assessing the Severity of Cervical Dystonia: Ask the Doctor or Ask the Patient?'. Together they form a unique fingerprint.

Cite this