Possible risk factors for primary adult onset dystonia: a case-control investigation by the Italian Movement Disorders Study Group
- Giovanni Defazioa,
- Alfredo Berardellib,
- Giovanni Abbruzzesec,
- Vito Leporea,
- Vincenzo Coviellod,
- Diomira Acquistapacea,
- Livio Capuse,
- Francesco Carellaf,
- Maria Teresa De Berardinisg,
- Giuseppe Galardih,
- Paolo Girlandai,
- Silvio Maurrij,
- Alberto Albanesek,
- Laura Bertolasil,
- Rocco Liguorim,
- Aroldo Rossin,
- Lucio Santoroo,
- Gianni Tognonip,
- Paolo Livreaa
- aInstitute of Neurology, University of Bari, bDepartment of Neurology, University of Rome, cInstitute of Neurology, University of Genova, dDepartment of Preventive Medicine ASL BA1, Andria, eInstitute of Neurology, University of Trieste, fIstituto Nazionale Neurologico C Besta, Milan, gInstitute of Ophthalmology, University of Naples, hInstitute of Neurology, S Raffaele Hospital, Milan, i2nd Neurologic Clinic, University of Messina, j2nd Neurologic Clinic, University of Firenze, kInstitute of Neurology, “Università Cattolica del Sacro Cuore”, Rome, lInstitute of Neurology, University of Verona, mInstitute of Neurology, University of Bologna, nInstitute of Neurology, University of Perugia, o2nd Neurologic Clinic, University of Naples, p“Consorzio Mario Negri Sud“, S Maria Imbaro, Italy
- Dr Giovanni Defazio, Institute of Neurology of the University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy. Telephone 0039 80 5478511; fax 0039 80 5478532.
- Received 20 March 1997
- Revised 13 June 1997
- Accepted 30 June 1997
Abstract
OBJECTIVES Little is known about the aetiology of idiopathic adult onset dystonia. The Italian Movement Disorders Study Group promoted a case-control study on some hypothetical risk factors including past medical events, life events, life habits, occupational hazards, and family hystory of dystonia, parkinsonism, and tremor.
METHODS Cases affected by idiopathic adult onset dystonia (age at symptom onset >20 years, duration of disease >one year and <five years) were selected among consecutive outpatients attending 14 Italian centres. Control outpatients matched for age (±5 years), sex, and referral centre were identified among diagnostic categories thought to be unassociated with study exposures. Information was obtained by a standardised questionnaire administered by medical interviewers. Conditional logistic univariate and multivariate regression analyses were performed by a standard statistical package.
RESULTS Multivariate analysis on 202 cases and 202 age and sex matched control outpatients indicated that head or facial trauma with loss of consciousness, family history of dystonia, and family history of postural tremor independently increased the risk of developing adult onset dystonia, whereas hypertension and cigarette smoking exerted a protective effect. The findings also suggested a positive association between local body injury—for example, previous ocular diseases and neck or trunk trauma—and dystonia of the same body part.
CONCLUSIONS The results support the idea that environmental and genetic factors may both be important in the aetiology of adult onset dystonia, and suggest aetiological clues worthy of further analytical investigation.
- adult onset dystonia
- trauma
- eye diseases
- cigarette smoking
- family history of dystonia
- family history of tremor
