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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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