Ricerc@Sapienza

Cervical dystonia (CD) has long been considered to be a motor disorder. However, CD seems to represent an extremely heterogeneous condition. Indeed, it has become clear that beyond motor manifestations, patients with CD may also complain of non motor symptoms, including psychiatric disorders, pain, cognitive and sleep disorders. Non-motor symptoms represent an important determinant of quality of life and a source of disability in CD. Previous studies aimed to disentangle the complex relationship between motor and non motor symptoms have yielded conflicting results. In addition several CD subtypes have been so far identified only considering motor features. Therefore, the role of non-motor symptoms in determining clinical heterogeneity in CD is still unclear. The first line of treatment for motor symptoms in CD is botulinum toxin (BoNT) injection therapy. Conversely, no study has so far investigated whether the treatment with BoNT may also improve non-motor burden in CD.On this background, the main aim of this study is to identify clinical CD subtypes on the basis of motor and non-motor symptoms. A second aim of this study is to longitudinally evaluate the effect of BoNT treatment on motor and non-motor symptoms. Finally, the last aim is to explore the relationship between motor features, as tested by kinematic techniques, and non-motor symptoms in CD. For these purposes, we will enroll 80 CD patients and 80 healthy controls. We will investigate five clinical domains, including motor symptoms, psychiatric disturbances, sleep disorders, cognitive impairment and pain, by using standardized clinical scales and kinematic recording of dystonic movements. These domains will be used as variables in a k-means cluster analysis. A correlation analysis between kinematic data and non-motor manifestations will be performed. Finally we will perform a longitudinal evaluation by assessing non-motor symptoms severity before and 1 and 3 months after botulinum toxin injection.