Jeanne P Vu, Elizabeth Cisneros, Jerry Zhao, Ha Yeon Lee, Joseph Jankovic, Stewart A Factor, Christopher G Goetz, Richard L Barbano, Joel S Perlmutter, Hyder A Jinnah, Sarah Pirio Richardson, Glenn T Stebbins, Rodger J Elble, Cynthia L Comella, David A Peterson
Introduction: A common view is that head tremor (HT) in cervical dystonia (CD) decreases when the head assumes an unopposed dystonic posture and increases when the head is held at midline. However, this has not been examined with objective measures in a large, multicenter cohort.
Methods: For 80 participants with CD and HT, we analyzed videos from examination segments in which participants were instructed to 1) let their head drift to its most comfortable position (null point) and then 2) hold their head straight at midline. We used our previously developed Computational Motor Objective Rater (CMOR) to quantify changes in severity, amplitude, and frequency between the two postures.
Results: Although up to 9% of participants had exacerbated HT in midline, across the whole cohort, paired t-tests reveal no significant changes in overall severity (t = -0.23, p = 0.81), amplitude (t = -0.80, p = 0.43), and frequency (t = 1.48, p = 0.14) between the two postures.
Conclusions: When instructed to first let their head drift to its null point and then to hold their head straight at midline, most patient's changes in HT were below the thresholds one would expect from the sensitivity of clinical rating scales. Counter to common clinical impression, CMOR objectively showed that HT does not consistently increase at midline posture in comparison to the null posture.
一种常见的观点是，当头部处于非对位张力障碍姿势时，头震颤(HT)减少，而当头部处于中线时，头震颤(HT)增加。然而，这还没有在一个大的、多中心的队列中进行客观的测量。方法:对于80名患有CD和HT的参与者，我们分析了来自检查片段的视频，在这些视频中，参与者被指示1)让他们的头部漂移到最舒适的位置(零点)，然后2)将他们的头部保持在中线上。我们使用之前开发的计算运动客观评分(cmorr)来量化两种姿势之间的严重程度、幅度和频率的变化。结果:尽管高达9%的参与者在中线加重了HT，但在整个队列中，配对t检验显示两种姿势之间的总体严重程度(t = -0.23, p = 0.81)、幅度(t = -0.80, p = 0.43)和频率(t = 1.48, p = 0.14)没有显着变化。结论:当被指示先让他们的头部漂移到零点，然后将他们的头部保持在中线时，大多数患者的HT变化低于临床评定量表的敏感性所期望的阈值。与常见的临床印象相反，cor客观地显示中线位与空位相比，HT并没有持续增加。
{"title":"From null to midline: changes in head posture do not predictably change head tremor in cervical dystonia.","authors":"Jeanne P Vu, Elizabeth Cisneros, Jerry Zhao, Ha Yeon Lee, Joseph Jankovic, Stewart A Factor, Christopher G Goetz, Richard L Barbano, Joel S Perlmutter, Hyder A Jinnah, Sarah Pirio Richardson, Glenn T Stebbins, Rodger J Elble, Cynthia L Comella, David A Peterson","doi":"10.3389/dyst.2022.10684","DOIUrl":"https://doi.org/10.3389/dyst.2022.10684","url":null,"abstract":"<p><strong>Introduction: </strong>A common view is that head tremor (HT) in cervical dystonia (CD) decreases when the head assumes an unopposed dystonic posture and increases when the head is held at midline. However, this has not been examined with objective measures in a large, multicenter cohort.</p><p><strong>Methods: </strong>For 80 participants with CD and HT, we analyzed videos from examination segments in which participants were instructed to 1) let their head drift to its most comfortable position (null point) and then 2) hold their head straight at midline. We used our previously developed Computational Motor Objective Rater (CMOR) to quantify changes in severity, amplitude, and frequency between the two postures.</p><p><strong>Results: </strong>Although up to 9% of participants had exacerbated HT in midline, across the whole cohort, paired t-tests reveal no significant changes in overall severity (t = -0.23, p = 0.81), amplitude (t = -0.80, p = 0.43), and frequency (t = 1.48, p = 0.14) between the two postures.</p><p><strong>Conclusions: </strong>When instructed to first let their head drift to its null point and then to hold their head straight at midline, most patient's changes in HT were below the thresholds one would expect from the sensitivity of clinical rating scales. Counter to common clinical impression, CMOR objectively showed that HT does not consistently increase at midline posture in comparison to the null posture.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128866/pdf/nihms-1880525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9352836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号