Does raising the arms modify head tremor severity in cervical dystonia?

Elizabeth Cisneros, Jeanne P. Vu, Ha Yeon Lee, Qiyu Chen, Casey N. Benadof, Zheng Zhang, Emily A. Pettitt, Subhagya K. Joshi, Richard L. Barbano, Joseph Jankovic, Hyder A. Jinnah, Joel S. Perlmutter, Brian D. Berman, Abhimanyu Mahajan, Christopher G. Goetz, Glenn T. Stebbins, Cynthia L. Comella, David A. Peterson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A defining characteristic of dystonia is its position-dependence. In cervical dystonia (CD), sensory tricks ameliorate head tremor (HT). But it remains unknown whether raising the arms alone has the same impact. Methods: We analyzed data collected from patients enrolled by the Dystonia Coalition. For 120 patients with HT, we assessed how raising their arms without touching their head changed their HT severity. Results: Forty-eight out of 120 patients exhibited changes in HT severity when raising their arms. These patients were more likely to exhibit decreases in HT severity (N = 35) than increases (N = 13, χ2 (1, N = 48) = 10.1, p = 0.002). Demographic factors and sensory trick efficacy were not significant predictors of whether HT severity changed when raising their arms. Discussion: Raising the arms without touching the head is a posture that can reduce HT severity in some CD patients. Our results extend the concept of position-dependent motor symptoms in CD to include the position of the arms. Highlights Head tremor (HT) is a prevalent symptom of cervical dystonia (CD) that can often be disabling. This study demonstrates that raising the arms without touching the head is a posture that can reduce HT severity in some CD patients. Our findings also identify a novel form of position-dependence in CD.

Original languageEnglish
Article number21
JournalTremor and Other Hyperkinetic Movements
Volume11
Issue number1
DOIs
StatePublished - 2021

Keywords

  • Cervical dystonia
  • Dystonic tremor
  • Head tremor
  • Posture

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