Predictors of alcohol responsiveness in dystonia

Johanna Junker, Valerie Brandt, Brian D. Berman, Marie Vidailhet, Emmanuel Roze, Anne Weissbach, Cynthia Comella, Irene A. Malaty, Joseph Jankovic, Mark S. Ledoux, Alfredo Berardelli, Richard Barbano, Stephen G. Reich, Joel S. Perlmutter, H. A. Jinnah, Norbert Bruggemann

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective To determine predictors of alcohol responsiveness in a large cohort of patients with dystonia. Methods A total of 2,159 participants with dystonia were prospectively enrolled in the cross-sectional Dystonia Coalition multicenter study. Patients with secondary, combined, or confirmed genetic dystonia (total n = 164) or unknown alcohol responsiveness (n = 737) were excluded. Patients answered a standardized questionnaire and were clinically examined using a standardized video protocol and the Burke-Fahn-Marsden Dystonia Rating Scale. Alcohol responsiveness was determined by patients' self-report. Results A total of 1,258 patientswith isolated dystonia (mean age: 59.5 ± 12.2 years; 898 women) met the inclusion criteria; 369 patients (29.3%) reported improvement of dystonia after alcohol consumption. Alcohol responsiveness was not related to sex (p = 0.742), age (p = 0.715), or severity of dystonia (p = 0.623). Age at onset was lower in patients who responded to alcohol (p < 0.001). Alcohol responsiveness differed across dystonia subgroups (multifocal/generalized > segmental [p = 0.014]; cervical and laryngeal > cranial and limb [p < 0.001]) and was related to a positive family history of movement disorders (p = 0.001), and presence of tremor (p < 0.001). Conclusion The association of alcohol responsiveness with a positive family history for movement disorders, generalized dystonia, and an earlier age at onset suggests that patients with dystonia who have an underlying genetic contribution may be more likely to respond beneficially to alcohol. The fact that dystonic tremor may respond to alcohol is in keeping with the observation that the intake of GABAergic drugs may have a beneficial effect in a proportion of patients.

Original languageEnglish
Pages (from-to)E2020-E2026
JournalNeurology
Volume91
Issue number21
DOIs
StatePublished - Nov 20 2018

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