title: Cervical dystonia and pain: characteristics and treatment patterns from CD PROBE (Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy).
abstract: To compare profiles of subjects with and without cervical dystonia (CD)-associated pain, to evaluate the contribution of pain and the motor component of CD on quality of life, and to compare the initial botulinum toxin treatment paradigm between pain groups, baseline data were used from the CD Patient Registry for Observation of OnabotulinumtoxinA Efficacy (CD PROBE), a multicenter, prospective, observational registry designed to capture real-world practices and outcomes for onabotulinumtoxinA CD treatment. Subjects were divided into no/mild pain [Pain Numeric Rating Scale (PNRS) score 0-3] and moderate/severe pain groups (PNRS score 4-10). Descriptive and differential statistics were utilized to compare groups. 1,037 subjects completed the first treatment session, reported baseline botulinum toxin status, and completed baseline PNRS. Those with no/mild pain were significantly older at baseline. Those subjects with moderate/severe pain had higher Toronto Western Spasmodic Torticollis Rating Scale Severity (17.7 ± 5.1 vs. 16.2 ± 5.6, p < 0.0001) and Disability (12.7 ± 6.1 vs. 7.5 ± 5.6, p < 0.0001). CD subjects with moderate/severe pain received a higher mean dose (177.3 ± 82.9 vs. 158.0 ± 67.1 U, p = 0.0001) of onabotulinumtoxinA and were injected in more muscles (4.1 ± 1.4 vs. 3.7 ± 1.2, p < 0.0001) at initial treatment. CD PROBE clearly demonstrates the frequency of pain in CD and substantiates its importance when determining an optimal treatment paradigm. Future analyses of CD PROBE will further our understanding of the treatment patterns and outcomes related to onabotulinumtoxinA therapy for this disabling condition.
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave S, Suite A-1106 MCN, Nashville, TN, 37272, USA, david.charles@vanderbilt.edu.
authors.forename: P David
authors.initials: PD
authors.lastname: Charles
authors.forename: Charles H
authors.initials: CH
authors.lastname: Adler
authors.forename: Mark
authors.initials: M
authors.lastname: Stacy
authors.forename: Cynthia
authors.initials: C
authors.lastname: Comella
authors.forename: Joseph
authors.initials: J
authors.lastname: Jankovic
authors.forename: Aubrey
authors.initials: A
authors.lastname: Manack Adams
authors.forename: Marc
authors.initials: M
authors.lastname: Schwartz
authors.forename: Mitchell F
authors.initials: MF
authors.lastname: Brin
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D019370:Observation; D010146:Pain / Q000150:complications*; D010147:Pain Measurement; D011788:Quality of Life; D012042:Registries; D012189:Retrospective Studies; D014103:Torticollis / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D014481:United States
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
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