Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia
Abstract Background: Non‐motor symptoms are well established phenotypic components of adult‐onset idiopathic, isolated, focal cervical dystonia (AOIFCD). However, improved understanding of their clinical heterogeneity is needed to better target therapeutic intervention. Here, we examine non‐motor ph...
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Wiley
2021-08-01
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Series: | Brain and Behavior |
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Online Access: | https://doi.org/10.1002/brb3.2292 |
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doaj-d319ab97d6344ddf9b097d56ff0ee105 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Megan E. Wadon Grace A. Bailey Zehra Yilmaz Emily Hubbard Meshari AlSaeed Amy Robinson Duncan McLauchlan Richard L. Barbano Laura Marsh Stewart A. Factor Susan H. Fox Charles H. Adler Ramon L. Rodriguez Cynthia L. Comella Stephen G. Reich William L. Severt Christopher G. Goetz Joel S. Perlmutter Hyder A. Jinnah Katharine E. Harding Cynthia Sandor Kathryn J. Peall |
spellingShingle |
Megan E. Wadon Grace A. Bailey Zehra Yilmaz Emily Hubbard Meshari AlSaeed Amy Robinson Duncan McLauchlan Richard L. Barbano Laura Marsh Stewart A. Factor Susan H. Fox Charles H. Adler Ramon L. Rodriguez Cynthia L. Comella Stephen G. Reich William L. Severt Christopher G. Goetz Joel S. Perlmutter Hyder A. Jinnah Katharine E. Harding Cynthia Sandor Kathryn J. Peall Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia Brain and Behavior dystonia disorders phenotype surveys and questionnaires torticollis |
author_facet |
Megan E. Wadon Grace A. Bailey Zehra Yilmaz Emily Hubbard Meshari AlSaeed Amy Robinson Duncan McLauchlan Richard L. Barbano Laura Marsh Stewart A. Factor Susan H. Fox Charles H. Adler Ramon L. Rodriguez Cynthia L. Comella Stephen G. Reich William L. Severt Christopher G. Goetz Joel S. Perlmutter Hyder A. Jinnah Katharine E. Harding Cynthia Sandor Kathryn J. Peall |
author_sort |
Megan E. Wadon |
title |
Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
title_short |
Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
title_full |
Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
title_fullStr |
Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
title_full_unstemmed |
Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
title_sort |
non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystonia |
publisher |
Wiley |
series |
Brain and Behavior |
issn |
2162-3279 |
publishDate |
2021-08-01 |
description |
Abstract Background: Non‐motor symptoms are well established phenotypic components of adult‐onset idiopathic, isolated, focal cervical dystonia (AOIFCD). However, improved understanding of their clinical heterogeneity is needed to better target therapeutic intervention. Here, we examine non‐motor phenotypic features to identify possible AOIFCD subgroups. Methods: Participants diagnosed with AOIFCD were recruited via specialist neurology clinics (dystonia wales: n = 114, dystonia coalition: n = 183). Non‐motor assessment included psychiatric symptoms, pain, sleep disturbance, and quality of life, assessed using self‐completed questionnaires or face‐to‐face assessment. Both cohorts were analyzed independently using Cluster, and Bayesian multiple mixed model phenotype analyses to investigate the relationship between non‐motor symptoms and determine evidence of phenotypic subgroups. Results: Independent cluster analysis of the two cohorts suggests two predominant phenotypic subgroups, one consisting of approximately a third of participants in both cohorts, experiencing increased levels of depression, anxiety, sleep impairment, and pain catastrophizing, as well as, decreased quality of life. The Bayesian approach reinforced this with the primary axis, which explained the majority of the variance, in each cohort being associated with psychiatric symptomology, and also sleep impairment and pain catastrophizing in the Dystonia Wales cohort. Conclusions: Non‐motor symptoms accompanying AOIFCD parse into two predominant phenotypic sub‐groups, with differences in psychiatric symptoms, pain catastrophizing, sleep quality, and quality of life. Improved understanding of these symptom groups will enable better targeted pathophysiological investigation and future therapeutic intervention. |
topic |
dystonia disorders phenotype surveys and questionnaires torticollis |
url |
https://doi.org/10.1002/brb3.2292 |
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doaj-d319ab97d6344ddf9b097d56ff0ee1052021-09-03T06:07:44ZengWileyBrain and Behavior2162-32792021-08-01118n/an/a10.1002/brb3.2292Non‐motor phenotypic subgroups in adult‐onset idiopathic, isolated, focal cervical dystoniaMegan E. Wadon0Grace A. Bailey1Zehra Yilmaz2Emily Hubbard3Meshari AlSaeed4Amy Robinson5Duncan McLauchlan6Richard L. Barbano7Laura Marsh8Stewart A. Factor9Susan H. Fox10Charles H. Adler11Ramon L. Rodriguez12Cynthia L. Comella13Stephen G. Reich14William L. Severt15Christopher G. Goetz16Joel S. Perlmutter17Hyder A. Jinnah18Katharine E. Harding19Cynthia Sandor20Kathryn J. Peall21Neuroscience and Mental Health Research Institute Division of Psychological Medicine and Clinical Neurosciences Cardiff University Maindy Road Cardiff CF24 4HQ UKNeuroscience and Mental Health Research Institute Division of Psychological Medicine and Clinical Neurosciences Cardiff University Maindy Road Cardiff CF24 4HQ UKNeuroscience and Mental Health Research Institute Division of Psychological Medicine and Clinical Neurosciences Cardiff University Maindy Road Cardiff CF24 4HQ UKSchool of Medicine Cardiff University Heath Park Campus Cardiff CF14 4YS UKSchool of Medicine Cardiff University Heath Park Campus Cardiff CF14 4YS UKSchool of Medicine Cardiff University Heath Park Campus Cardiff CF14 4YS UKNeuroscience and Mental Health Research Institute Division of Psychological Medicine and Clinical Neurosciences Cardiff University Maindy Road Cardiff CF24 4HQ UKDepartment of Neurology University of Rochester Elmwood Avenue Rochester New York NY 14642 USAMenninger Department of Psychiatry Baylor College of Medicine Butler Boulevard Houston Texas 77030 USADepartments of Neurology & Human Genetics Emory University Woodruff Circle Atlanta Georgia 30322 USAEdmond J Safra Program in Parkinson Disease Movement Disorder Clinic Toronto Western Hospital Bathurst Street Toronto Ontario M5T 2S8 CanadaThe Parkinson's Disease and Movement Disorders Center Mayo Clinic Department of Neurology East Shea Boulevard Scottsdale Arizona 85259 USADepartment of Neurology University of Florida Newell Drive Gainesville Florida 32611 USADepartment of Neurological Sciences Rush University Medical Center West Harrison Street Chicago Illinois 60612 USADepartment of Neurology University of Maryland School of Medicine south Paca Street Baltimore Maryland 21201 USABeth Israel Medical Center First Avenue New York New York 10003 USADepartment of Neurological Sciences Rush University Medical Center West Harrison Street Chicago Illinois 60612 USANeurology Radiology Neuroscience Physical Therapy and Occupational Therapy Washington University School of Medicine South Euclid Avenue St. Louis Missouri 63110 USADepartments of Neurology & Human Genetics Emory University Woodruff Circle Atlanta Georgia 30322 USADepartment of Neurology Aneurin Bevan University Health Board Corporation Road Newport NP19 0BH UKUK Dementia Research Institute Cardiff University Maindy Road Cardiff CF24 4HQ UKNeuroscience and Mental Health Research Institute Division of Psychological Medicine and Clinical Neurosciences Cardiff University Maindy Road Cardiff CF24 4HQ UKAbstract Background: Non‐motor symptoms are well established phenotypic components of adult‐onset idiopathic, isolated, focal cervical dystonia (AOIFCD). However, improved understanding of their clinical heterogeneity is needed to better target therapeutic intervention. Here, we examine non‐motor phenotypic features to identify possible AOIFCD subgroups. Methods: Participants diagnosed with AOIFCD were recruited via specialist neurology clinics (dystonia wales: n = 114, dystonia coalition: n = 183). Non‐motor assessment included psychiatric symptoms, pain, sleep disturbance, and quality of life, assessed using self‐completed questionnaires or face‐to‐face assessment. Both cohorts were analyzed independently using Cluster, and Bayesian multiple mixed model phenotype analyses to investigate the relationship between non‐motor symptoms and determine evidence of phenotypic subgroups. Results: Independent cluster analysis of the two cohorts suggests two predominant phenotypic subgroups, one consisting of approximately a third of participants in both cohorts, experiencing increased levels of depression, anxiety, sleep impairment, and pain catastrophizing, as well as, decreased quality of life. The Bayesian approach reinforced this with the primary axis, which explained the majority of the variance, in each cohort being associated with psychiatric symptomology, and also sleep impairment and pain catastrophizing in the Dystonia Wales cohort. Conclusions: Non‐motor symptoms accompanying AOIFCD parse into two predominant phenotypic sub‐groups, with differences in psychiatric symptoms, pain catastrophizing, sleep quality, and quality of life. Improved understanding of these symptom groups will enable better targeted pathophysiological investigation and future therapeutic intervention.https://doi.org/10.1002/brb3.2292dystonia disordersphenotypesurveys and questionnairestorticollis |