Cognitive impairment in Chinese patients with cervical dystonia

Abstract

ObjectiveCognitive impairment (CI) in patients with cervical dystonia (CD) has been reported in many studies but with inconsistent findings. We investigated the prevalence, characteristics, and clinical factors related to CI in Chinese patients with CD.MethodsSixty-eight patients with CD and 68 healthy controls (HCs) were included in the study. Demographic and clinical data were investigated. A logistic regression analysis was conducted to discriminate the clinical factors associated with CI in patients with CD. A cluster analysis was performed to explore the different characteristics within the group of CD patients with CI.ResultsWe found that 42 (61.76%) patients with CD had CI. The most frequent CI domain was visuospatial function (39.71%), followed by memory (38.24%), attention/working memory (29.41%), language (25.00%), and executive function (23.53%). CD patients with CI were older, less educated, had an older age of onset, more severe motor symptoms and disability, and experienced more pain than CD patients without CI. The presence of CI in patients with CD was associated with less education (OR = 0.802, p = 0.034) and a higher Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity subscore (OR = 1.305, p = 0.001). The cluster analysis identified two different subgroups of patients, one with relatively mild cognitive impairment and the other with relatively severe cognitive impairment.ConclusionCI is relatively common in Chinese patients with CD, with the most common CI domain of the visuospatial function. In the present study, CI in patients with CD was associated with less education and more severe motor symptoms, and patients with CI may be further divided into two subgroups based on different extent and domain of cognitive decline.

Are Cognitive Symptoms Part of the Phenotypic Spectrum of Idiopathic Adult‐Onset Dystonia? Summary of Evidence from Controlled Studies

“…In addition, some studies checked for possible influence of anxiety and depression on the association between altered cognitive performance and case status, but no appreciable confounding effect could be detected. 6,9,10,14,19 This would suggest against the hypothesis that cognitive impairment is secondary to motor features (dystonia or tremor) or depression. Available data therefore indicated that mild cognitive impairment may be a feature associated with IAOD.…”

“…Altered cognitive performance was independent of motor symptoms in 7 of 10 studies that assessed the relationship between cognitive impairment and severity of motor symptoms. In addition, some studies checked for possible influence of anxiety and depression on the association between altered cognitive performance and case status, but no appreciable confounding effect could be detected 6,9,10,14,19 . This would suggest against the hypothesis that cognitive impairment is secondary to motor features (dystonia or tremor) or depression.…”

“…The data extracted from the 22 selected studies are summarized in detail in Table S1. People with dystonia performed significantly worse than healthy controls in 18 studies [6][7][8][9][10][11][12][13][14][17][18][19][20][21]23,[25][26][27] and not significantly different from healthy controls in 4. 15,16,22,24 Therefore, we observed a nonsignificant trend for a greater proportion of studies reporting abnormal cognitive performance in people with dystonia (82% vs. 18%, P = 0.07).…”

“…Mean casecontrol ratio AE SD was close to 1 in those studies that reported abnormal cognitive performance in people with dystonia as in those that did not (1.16 + 0.41 vs. 0.92 + 0.09, P = 0.2). The majority of studies reporting abnormal cognitive performance in people with dystonia (15 of 18, 83% 8,10,[17][18][19][20][21]23,[25][26][27] ), but also a relevant proportion of the other studies (2 of 4, 50% 15,24 ), were published in the past 10 years, which probably makes a publication bias unlikely.…”

Factors influencing cognitive function in patients with Huntington's disease from China: A cross‐sectional clinical study

“…Moreover, in letter VFT, participants have to produce as many words as possible beginning with Chinese characters "Tian," "Yue," and "Hao" (Boll et al, 1974;Liu et al, 2022). Paper-version SDMT (Smith, 1973) is a simple substitution task, which gives the participants 90 s to pair specific numbers with given geometric figures with written responses.…”