A survey of lifestyle factors in dystonia

Abstract

is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned, twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action associated with overflow muscle activation." (Albanese et al., 2013). Dystonia was first described in 1911, but still today the definition is being updated and debated (Albanese et al., 2013; De Pablo-Fernandez & Warner, 2017). The latest updated definition, quoted above, was presented in 2013. In addition to motor symptoms, increasing evidence indicates that nonmotor symptoms are troublesome for patients (Stamelou et al., 2012), leading to reduced quality of life (Müller et al., 2002; Timmers et al., 2017). Nonmotor symptoms can be pain, impaired sensory functions, neuropsychiatric disorders, sleep disturbances, and cognitive disturbances (Kuyper et al., 2011; Stamelou et al., 2012). There is a reported connection between dystonia and psychiatric disorders, such as generalized anxiety disorder, obsessive-compulsive disorder, alcohol dependence, and depression. Whether these symptoms are effects of dystonia or side effects of treatment remains unclear. A coherent understanding about the prevalence and risk factors for dystonia is still missing. Studies on prevalence of dystonia present varying numbers, ranging from 5 to 40 per 100,000 (Government of Canada and Neurological Health Charities Canada, 2014; Steeves et al., 2012) A systematic review by Krewski et al. (2017) found possible susceptibility to cervical dystonia among females. For blepharospasm, they proposed that there is no significant gender difference. Higher, rather than lower, consumption of coffee and alcohol has shown to be protective for onset of specific forms of dystonia, blepharospasm, and myoclonal dystonia, respectively, although the protective effect of alcohol is debated (Krewski et al., 2017).