Possible risk factors for primary adult onset dystonia: a case-control investigation by the Italian Movement Disorders Study Group

Abstract

Objectives-Little is known about the aetiology of idiopathic adult onset dystonia. The Italian Movement Disorders Study Group promoted a case-control study on some hypothetical risk factors including past medical events, life events, life habits, occupational hazards, and family hystory of dystonia, parkinsonism, and tremor. Methods-Cases aVected by idiopathic adult onset dystonia (age at symptom onset >20 years, duration of disease >one year and <five years) were selected among consecutive outpatients attending 14 Italian centres. Control outpatients matched for age (±5 years), sex, and referral centre were identified among diagnostic categories thought to be unassociated with study exposures. Information was obtained by a standardised questionnaire administered by medical interviewers. Conditional logistic univariate and multivariate regression analyses were performed by a standard statistical package. Results-Multivariate analysis on 202 cases and 202 age and sex matched control outpatients indicated that head or facial trauma with loss of consciousness, family history of dystonia, and family history of postural tremor independently increased the risk of developing adult onset dystonia, whereas hypertension and cigarette smoking exerted a protective eVect. The findings also suggested a positive association between local body injury-for example, previous ocular diseases and neck or trunk trauma-and dystonia of the same body part. Conclusions-The results support the idea that environmental and genetic factors may both be important in the aetiology of adult onset dystonia, and suggest aetiological clues worthy of further analytical investigation. (J Neurol Neurosurg Psychiatry 1998;64:25-32)

Animal Models for Investigating Benign Essential Blepharospasm

“…Such an increased incidence of Parkinson’s disease, however, does not appear to occur in BEB patients [106]. The eye irritation environmental trigger, however, is consistent with the human data [36-39] and the evidence that changes in the basal ganglia plays a role in the predisposing condition is compelling [40, 97-99]. Thus, the Schicatano et al (1997) model [100] suggests an outline for abnormal neural circuit interactions that support BEB.…”

“…These characteristics are exaggerations of the normal blink adaptation to the corneal irritation created by dry eye [35]. Thus, it is not surprising that a significant proportion of patients report current or previous experiences of dry eye when first diagnosed with BEB [36-39]. Nevertheless, the vast majority of individuals with dry eye do not go on to develop BEB.…”

Clinical features and treatment with botulinum toxin in blepharospasm: a 17-year experience

“…A recently published well designed study found an evidence of ocular disease such as dry eye, blepharitis and keratoconjuctivitis in 50 of 140 patients with BPS 10 . Previous studies have showed non-significant associations between alcohol use, hypertension and minor head trauma (without loss of consciousness) with BPS 13 . On the other hand, head trauma with loss of consciousness 13 and as a protective caffeine intake 14 , have been suggested as a risk factor and as a protective factor, respectively.…”

“…Previous studies have showed non-significant associations between alcohol use, hypertension and minor head trauma (without loss of consciousness) with BPS 13 . On the other hand, head trauma with loss of consciousness 13 and as a protective caffeine intake 14 , have been suggested as a risk factor and as a protective factor, respectively. The lack of a control group in our study precluded confirmation of those associations.…”

“…We have to highlight that this data was acquired through patient report and that their family members were not examined in our center. Positive family history in previously published articles ranged from 7 to 32%, according to distinct methodology and population studied 8,12,13,15 .…”