Sensory Trick in Levodopa-induced Orolingual Dystonia in a Patient with Advanced Parkinson's Disease.
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ABSTRACT:
SUBMITTER: Georgiev D
PROVIDER: S-EPMC6353398 | biostudies-literature | 2017 Jan-Feb
REPOSITORIES: biostudies-literature
Publications
Sensory Trick in Levodopa-induced Orolingual Dystonia in a Patient with Advanced Parkinson's Disease.
Georgiev Dejan D Križnar Nina Župančič NŽ Pirtošek Zvezdan Z Kojović Maja M
Movement disorders clinical practice 20160610 1
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Project description:BackgroundSensory tricks (STs) are voluntary maneuvers that dampen the abnormal movement in cervical dystonia (CD).ObjectivesTo investigate the effect of ST on CD severity and treatment.MethodsData on 1039 individuals with a modified Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score were extracted from the CD Patient Registry for Observation of OnabotulinumtoxinA (onabotA) Efficacy study. Univariate and multivariate models evaluated the direct and indirect impact of ST on CD severity and treatment, while controlling for confounds.ResultsComplete ST was associated with a 10% lower mean onabotA dose. Absence of complete ST was associated with a higher onabotA dose after controlling for dystonia severity (OR = 1.37, P = 0.04). ST moderated the relationship between dystonia severity and toxin dose (β = -0.16, P = 0.02).ConclusionsST is related to lower CD severity and toxin dose. It may have a direct effect on lowering toxin dose, independent of CD severity.
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Project description:Choreiform or dystonic movement in the craniocervical region can occur as levodopa-induced dyskinesia (LID). "Sensory tricks" are various alleviating maneuvers for the relief of abnormal postures in patients who have idiopathic focal dystonia, particularly those who have cervical dystonia. The authors report on three men with Parkinson's disease who had been receiving levodopa for more than 3 years and presented with involuntary neck movements during the drug on period. In all three patients, cervical LIDs appeared during the drug on period and completely disappeared during the drug off period. The effects of using sensory tricks to markedly improve the symptoms of cervical LID were studied. In all patients, the cervical LIDs improved more efficiently when sensory tricks were performed on the patient by another person (passive tricks) than by the patient himself (self-sensory tricks). The unique features of the sensory tricks for cervical LID in the current patients may be important clinical evidence of abnormal sensorimotor integration in patients who have PD with LID.
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