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Primary cervical dystonia and scoliosis

A multicenter case-control study

From the Department of Neurologic and Psychiatric Sciences (Drs. Defazio, Martino, Masi, and Livrea), University of Bari; Department of Neurological Sciences and Vision (Drs. Abbruzzese, Marchese, and Mazzella), University of Genova; Department of Neurosciences, Psychiatry, and Anaesthesiology (Drs. Girlanda and Buccafusca), University of Messina; and Department of Neurological Sciences (Rome) and Institute NEUROMED (Pozzilli IS) (Drs. Currà, Vacca, and Berardelli), University of Rome "La Sapienza," Italy.

Address correspondence and reprint requests to Dr. Giovanni Defazio, Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy; e-mail: gdefazio{at}neurol.uniba.it

Objective: To study the distribution of prior scoliosis among patients with primary adult-onset cervical dystonia (CD) and matched control subjects.

Methods: Case and control subjects were selected among consecutive outpatients attending four Italian centers. Control outpatients were matched for age (±5 years), sex, and referral center. Information on prior scoliosis, other spine diseases, and family history of dystonia was obtained by a standardized questionnaire and supported by medical records. Conditional logistic regression models were used to adjust simultaneously for age, disease duration, and education level and to determine the independent association of exposure variables with the outcome.

Results: Prior scoliosis developing in middle or late childhood or at around the puberty occurred more frequently among 72 case patients than among 144 neurologic control subjects. No subject reported conditions considered to be responsible for secondary scoliosis. The association of scoliosis and CD was not confounded by age, duration of disease, education level, other spine diseases, or family history of dystonia (adjusted odds ratio [OR] 6.8; 95% CI 1.5 to 29.5; p = 0.011). The OR of family history of dystonia (18.7; 95% CI 2.4 to 147.5; p = 0.005) fell to 11.7 (95% CI 1.3 to 103; p = 0.03) after controlling for scoliosis.

Conclusions: Prior scoliosis may increase the risk of developing CD. The observed decrease in the magnitude of the association between family history of dystonia and CD after controlling for scoliosis suggests a link between the two conditions.

This article has been cited by other articles:

				G. Defazio, A. Berardelli, and M. Hallett Do primary adult-onset focal dystonias share aetiological factors? Brain, May 1, 2007; 130(5): 1183 - 1193. [Abstract] [Full Text] [PDF]