Abstract
Cervical dystonia (CD) is the most common form of focal dystonia. It is not known exactly whether abnormal head postures in cervical dystonia cause balance problems. Dual-tasking is a common every-day life situation. We aimed to evaluate postural stability (PS) in patients with CD and the effect of cognitive task on PS. As a secondary aim, we evaluated the effect of onabotulinum toxin A (BoNT) injection on PS. A total of 24 patients with CD who were on BoNT treatment for at least one year and 23 healthy controls were included. Posturographic analyses were carried out in all the subjects on static posturography platform under four different conditions: eyes open, eyes closed, tandem stance and cognitive task. In patients, posturographic analysis was carried out just before the BoNT injections and was repeated four weeks later. Before treatment, the anterior-posterior sway was significantly higher in CD patients with the eyes open condition compared to the controls (p=0.03). Cognitive task significantly affected several sway velocities. Tandem stance significantly affected many sway parameters, whereas the eyes closed condition did not. After treatment, only two parameters in tandem stance and one in cognitive task improved within the patient group, in a pairwise comparison. Postural control is impaired in CD patients probably due to the impaired proprioceptive and sensorimotor integration. In reference to dual task theories possibly due to divided attention and task prioritization, cognitive dual-task and harder postural task disturbes the PS in these patients.
Highlights
Cervical dystonia (CD) is the most common form of focal dystonia
Participants Demographic features of the subjects are shown in Posturographic parameters With the baseline eyes open (EO) condition, only A-P sway and sway path velocity were significantly higher in CD than in controls
eyes closed (EC) did not have any effect on postural stability (PS), whereas tandem stance with eyes closed (TAN) affected almost all sway parameters in CD significantly (Table 4)
Summary
Its prevelance ranges from 20‒4,100 cases/million[1] It causes involuntary contraction of neck muscles, leading to tonic or clonic head movements, subsequently resulting in sustained abnormal head postures. It has several types: torticollis, laterocollis, anterocollis and retrocollis. Cervical dystonia (CD) is the most common form of focal dystonia It is not known exactly whether abnormal head postures in cervical dystonia cause balance problems. Results: Before treatment, the anterior-posterior sway was significantly higher in CD patients with the eyes open condition compared to the controls (p=0.03). Tandem stance significantly affected many sway parameters, whereas the eyes closed condition did not. In reference to dual task theories possibly due to divided attention and task prioritization, cognitive dual-task and harder postural task disturbes the PS in these patients
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