title: Dystonia treatment: Patterns of medication use in an international cohort.
abstract: OBJECTIVE
  To determine the frequency of medication use in patients with dystonia enrolled in an international biorepository study.
  
  
  METHODS
  In a cross-sectional analysis, we included 2,026 participants enrolled at 37 sites in the United States, Canada, Europe, and Australia through Project 1 of the Dystonia Coalition, an international biorepository study. The primary aim was to assess the frequency of medication classes recommended for treating patients with dystonia, and the secondary aim was to compare characteristics (disease type, age, sex, duration of disease, comorbid conditions, severity).
  
  
  RESULTS
  Querying the database for the presence of any medication for dystonia used (includes both injectable and oral therapy), we found 73% using medications (n = 1,488) and 27% using no dystonia medications (n = 538). Furthermore, 61% of the total sample used botulinum toxin (BoNT) therapy alone or in combination. Differences were found in medication use patterns by dystonia type, with the lowest oral medication use in focal dystonia and highest use in generalized dystonia; by region, with highest BoNT therapy rate reported in Italy and the lowest in the Northeast region of the United States; and by focal dystonia subtype, with highest BoNT therapy alone in blepharospasm and spasmodic dysphonia (49%) and lowest in other cranial dystonia (32%).
  
  
  CONCLUSIONS
  The majority of patients with dystonia enrolled in the Dystonia Coalition Project 1 were using medications to treat their dystonia. Overall, a complex picture of medication use patterns emerged, with factors such as region, disease duration, type of dystonia, disease severity, and psychiatric comorbidities all playing a significant role.
authors.affiliation: From the Departments of Neurology (S.P.R., A.R.W., A.D.) and Family and Community Medicine (B.S.), University of New Mexico Health Sciences Center, Albuquerque; and Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University School of Medicine, Atlanta, GA. spiriorichardson@salud.unm.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pirio Richardson
authors.affiliation: From the Departments of Neurology (S.P.R., A.R.W., A.D.) and Family and Community Medicine (B.S.), University of New Mexico Health Sciences Center, Albuquerque; and Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University School of Medicine, Atlanta, GA.
authors.forename: Ashley R
authors.initials: AR
authors.lastname: Wegele
authors.affiliation: From the Departments of Neurology (S.P.R., A.R.W., A.D.) and Family and Community Medicine (B.S.), University of New Mexico Health Sciences Center, Albuquerque; and Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University School of Medicine, Atlanta, GA.
authors.forename: Betty
authors.initials: B
authors.lastname: Skipper
authors.affiliation: From the Departments of Neurology (S.P.R., A.R.W., A.D.) and Family and Community Medicine (B.S.), University of New Mexico Health Sciences Center, Albuquerque; and Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University School of Medicine, Atlanta, GA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Deligtisch
authors.affiliation: From the Departments of Neurology (S.P.R., A.R.W., A.D.) and Family and Community Medicine (B.S.), University of New Mexico Health Sciences Center, Albuquerque; and Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University School of Medicine, Atlanta, GA.
authors.forename: H A
authors.initials: HA
authors.lastname: Jinnah
mesh_terms: D001315:Australia; D002170:Canada; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D004421:Dystonia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States