Does raising the arms modify head tremor severity in cervical dystonia?

• Authors: Elizabeth Cisneros, Institute for Neural Computation; Jeanne P Vu, Institute for Neural Computation; Ha Yeon Lee, Institute for Neural Computation; Qiyu Chen, Institute for Neural Computation; Casey N Benadof, Institute for Neural Computation; Zheng Zhang, Institute for Neural Computation; Emily A Pettitt, Institute for Neural Computation; Subhagya K Joshi, Institute for Neural Computation; Richard L Barbano, University of Rochester; Joseph Jankovic, Baylor College of Medicine; Hyder Jinnah, Emory University; Joel S Perlmutter, Washington University School of Medicine in St. Louis; Brian D Berman, Virginia Commonwealth University; Abhimanyu Mahajan, Rush University Medical Center; Christopher G Goetz, Rush University Medical Center; Glenn T Stebbins, Rush University Medical Center; Cynthia L Comella, Rush University Medical Center; David A Peterson, Institute for Neural Computation
• Journal Title: Tremor and Other Hyperkinetic Movements
• Volume: Volume 11, Number 1
• Publisher: (publisher) | 2021-01-01, Pages 21-21
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.5334/tohm.623
• Subjects: Health Sciences, Radiology
• Keywords: cervical dystonia; dystonic tremor; head tremor; posture; Dystonic Disorders; Humans; Posture; Torticollis; Touch; Tremor

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, χ2 (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.