Alleviating manoeuvres (sensory tricks) in cervical dystonia.
BACKGROUND
There is limited information on the phenomenology, clinical characteristics and pathophysiology of alleviating manoeuvres (AM), also called 'sensory tricks' in cervical dystonia (CD).


METHODS
Individual data, collected from 10 sites participating in the Dystonia Coalition (http://clinicaltrials.gov/show/NCT01373424), included description of localisation and phenomenology of AM collected by systematic review of standardised video examinations. Analyses correlated demographic, neurologic, and psychiatric features of CD patients with or without effective AM.


RESULTS
Of 154 people studied, 138 (89.6%) used AM, of which 60 (43.4%) reported partial improvement, 55 (39.8%) marked improvement, and 4 (0.03%) no effect on dystonic posture. Light touch, usually to the lower face or neck, was used by >90%. The presence or location of AM did not correlate with the severity of the dystonia.


CONCLUSIONS
In this large and comprehensive study of CD, we found no clinical predictors of effective AM. Further studies of sensorimotor integration in dystonia are needed to better understand the pathophysiology of AM.
Department of Neurology and Neurotherapeutics, Center for Movement Disorders, University of Texas Southwestern, Dallas, Texas, USA.
Neepa
N
Patel
Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA.
John
J
Hanfelt
Departments of Psychiatry and Neurology, Baylor College of Medicine, Houston, Texas, USA.
Laura
L
Marsh
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
Joseph
J
Jankovic
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004576:Electromyography; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011187:Posture; D012737:Sex Factors; D014103:Torticollis / Q000503:physiopathology / Q000628:therapy*; D014110:Touch
cervical dystonia; geste antagoniste; sensorimotor integration; sensory; sensory trick