Set-shifting and behavioral dysfunction in primary focal dystonia.
The occurrence of cognitive and behavioral symptoms in patients with primary dystonia remains a matter of debate. We compared 45 patients with primary dystonia with 27 control subjects for performance on neuropsychological tasks with a load on executive-Wisconsin Card Sorting Test (WCST) and Stroop test, and visuospatial-Benton's visual retention test (BVRT) and Block assembly test from Wechsler Adult Intelligence Scale BAT-functions, as well as for intensity of obsessive-compulsive symptoms (Yale Brown Obsessive Compulsive Scale, Y-BOCS). Correlation analysis was performed between neuropsychological performance, dystonia characteristics (duration, age of onset) and severity (Unified Dystonia Rating Scale, UDRS), and Y-BOCS. Patients made more perseverative errors on the WCST (P = 0.042) and had a higher mean Y-BOCS (P = 0.003) score than controls. Timed tests (BVRT, BAT, Stroop test) correlated with UDRS. Y-BOCS, WCST, and UDRS scores were not significantly correlated with one another.These results suggest that patients with primary dystonia may have set-shifting deficits and a higher intensity of obsessive compulsive symptoms when compared to healthy subjects. This may reflect a pattern of complex neurophysiological dysfunction involving dorsolateral, orbitofrontal, and motor frontostriatal circuits.
Department of Neurology, Hospital Egas Moniz, Rua da Junqueira, Lisboa, Portugal. paulobugalho@sapo.pt
Paulo
P
Bugalho
Bernardo
B
Corrêa
João
J
Guimarães
Miguel
M
Xavier
D001288:Attention / Q000502:physiology*; D001526:Behavioral Symptoms / Q000209:etiology*; D020821:Dystonic Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012718:Set, Psychology; D012720:Severity of Illness Index