Demographic and clinical determinants of neck pain in idiopathic cervical dystonia
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NEUROLOGY AND PRECLINICAL NEUROLOGICAL STUDIES - SHORT COMMUNICATION
Demographic and clinical determinants of neck pain in idiopathic cervical dystonia Michele Tinazzi1 · Roberto Erro2 · Marcello Mario Mascia3 · Marcello Esposito4 · Tommaso Ercoli3 · Gina Ferrazzano5 · Francesca Di Biasio6 · Roberta Pellicciari7 · Roberto Eleopra8 · Francesco Bono9 · Laura Bertolasi10 · Paolo Barone2 · Cesa Lorella Maria Scaglione11 · Antonio Pisani12 · Maria Concetta Altavista13 · Maria Sofia Cotelli14 · Roberto Ceravolo15 · Giovanni Cossu16 · Maurizio Zibetti17 · Mario Coletti Moja18 · Paolo Girlanda19 · Luca Maderna20 · Alberto Albanese21 · Martina Petracca22,23 · Luca Magistrelli24,25 · Salvatore Misceo26 · Brigida Minafra27 · Marcello Romano28 · Giovanna Maddalena Squintani1 · Nicola Modugno29 · Marco Aguggia30 · Daniela Cassano31 · Anna Castagna32 · Francesca Morgante19,33 · Alfredo Berardelli5,29 · Giovanni Defazio3 Received: 5 May 2020 / Accepted: 13 August 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Cervical dystonia is associated with neck pain in a significant proportion of cases, but the mechanisms underlying pain are largely unknown. In this exploratory study, we compared demographic and clinical variables in cervical dystonia patients with and without neck pain from the Italian Dystonia Registry. Univariable and multivariable logistic regression analysis indicated a higher frequency of sensory trick and a lower educational level among patients with pain. Keywords Cervical dystonia · Pain · Basal ganglia · Nociception · Sensory trick
Introduction Cervical dystonia (CD), is characterized by abnormal patterned head movement/posture due to involuntary contraction of the neck muscles (Castagna and Albanese 2019; Defazio et al. 2017). CD is associated with neck pain in up to 75% of cases which significantly contributes to disability and poor quality of life (Avenali et al. 2018; Charles et al. 2014). The mechanisms underlying pain in CD are still largely unknown. Pain cannot be entirely attributed to muscle overactivity because botulinum toxin improves CD and pain to different degrees (Blackie and Lees 1990; Kulisevsky et al. 2000). Most likely, a central mechanism contributes to pain in CD, as suggested by a decrease in conditioned pain modulation (Tinazzi et al. 2019). Anomalies in descending pain inhibitory control are present in CD patients with and
* Tommaso Ercoli [email protected] Extended author information available on the last page of the article
without pain (Tinazzi et al. 2019), thus predisposing patients to pain, though other additional factors might be involved for the pain to manifest. Whether the demographic/clinical features of CD patients contribute to pain development has not been fully addressed to date. In this exploratory cross-sectional study involving a large cohort of CD patients, we assessed several demographic and clinical variables for their possible association with neck pain.
Methods Data were retrieved from the Italian Dystonia Registry (IDR) (Defazi
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