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Head trauma in primary cranial dystonias: A multi centre case control study
  1. Davide Martino
  1. Department of Neurological and Psychiatric sciences, University of Bari, Bari, Italy, Italy
    1. Giovanni Defazio (gdefazio{at}neurol.uniba.it)
    1. Department of Neurological and Psychiatric sciences, University of Bari, Bari, Italy, Italy
      1. Giovanni Abbruzzese
      1. Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy, Italy
        1. Paolo Girlanda
        1. Department of Neurosciences, Psychiatry and Anesthesiology, University of Messina, Messina, Italy, Italy
          1. Michele Tinazzi
          1. Department of Neurology, University of Verona, Verona, Italy, Italy
            1. Giovanni Fabbrini
            1. Department of Neurological Sciences, University of Rome “La Sapienza”, Rome, Italy, Italy
              1. Maria Stella Aniello
              1. Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy, Italy
                1. Laura Avanzino
                1. Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy, Italy
                  1. Carlo Colosimo
                  1. Department of Neurological Sciences, University of Rome “La Sapienza”, Rome, Italy, Italy
                    1. Giovanni Majorana
                    1. Department of Neurosciences, Psychiatry and Anesthesiology, University of Messina, Messina, Italy, Italy
                      1. Carlo Trompetto
                      1. Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy, Italy
                        1. Alfredo Berardelli
                        1. Department of Neurological Sciences and NEUROMED, University of Rome “La Sapienza”, Rome, Italy

                          Abstract

                          Background: The relationship between prior trauma and primary adult-onset dystonia is not well understood. Addressing this issue, previous uncontrolled observations and exploratory case-control studies yielded contradictory results.

                          Objective: To analyse the association between cranial dystonia and prior head trauma.

                          Methods: An ad hoc multi-centre case-control study was performed using a semi-structured interview to collect detailed information on the history of head trauma prior to disease onset in 5 Italian tertiary referral centres for movement disorders. The presence of a history of head trauma and of post-traumatic sequelae (loss of consciousness, bone fractures, scalp/facial wounds) prior to disease onset was recorded from 177 case patients with primary adult-onset cranial dystonia and 217 control patients with primary hemifacial spasm matched by age strata and gender. Differences between groups were assessed by Mann-Whitney U test and Fisher’s exact test, and the relationship between prior head trauma and case/control status was analysed by multiple-variable logistic regression models.

                          Results: We found no association betweenvault/maxillo- facial trauma and cranial dystonia. Most reported traumas occurred several years before disease onset. None of the main post-traumatic sequelae altered the chance of developing cranial dystonia, if compared to patients with primary HFS, nor did head trauma modify the age at onset of cranial dystonia.

                          Conclusions: These results do not support prior head trauma as a possible environmental factor modifying the risk of developing late-onset cranial dystonia. The lack of association may have pathogenetic and medical-forensic implications.

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