Does Raising the Arms Modify Head Tremor Severity in Cervical Dystonia?. Issue 1 (23rd June 2021)

• Record Type: Journal Article
• Authors: Cisneros, Elizabeth; Vu, Jeanne P.; Lee, Ha Yeon; Chen, Qiyu; Benadof, Casey N.; Zhang, Zheng; Pettitt, Emily A.; Joshi, Subhagya K.; Barbano, Richard L.; Jankovic, Joseph; Jinnah, Hyder A.; Perlmutter, Joel S.; Berman, Brian D.; Mahajan, Abhimanyu; Goetz, Christopher G.; Stebbins, Glenn T.; Comella, Cynthia L.; Peterson, David A.
• Is Part Of: Tremor and other hyperkinetic movements. Volume 11:Issue 1(2021)
• Publication Date: 2021-06-23
• Subjects: head tremor -- cervical dystonia -- dystonic tremor -- posture; Tremor -- Periodicals; Hyperkinesia -- Periodicals; 616.8
• DOI: 10.5334/tohm.623
• Languages: English
• ISSNs: 2160-8288

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, χ 2 (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.