RT Journal Article SR Electronic T1 Possible risk factors for primary adult onset dystonia: a case-control investigation by the Italian Movement Disorders Study Group JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 25 OP 32 DO 10.1136/jnnp.64.1.25 VO 64 IS 1 A1 Giovanni Defazio A1 Alfredo Berardelli A1 Giovanni Abbruzzese A1 Vito Lepore A1 Vincenzo Coviello A1 Diomira Acquistapace A1 Livio Capus A1 Francesco Carella A1 Maria Teresa De Berardinis A1 Giuseppe Galardi A1 Paolo Girlanda A1 Silvio Maurri A1 Alberto Albanese A1 Laura Bertolasi A1 Rocco Liguori A1 Aroldo Rossi A1 Lucio Santoro A1 Gianni Tognoni A1 Paolo Livrea YR 1998 UL http://jnnp.bmj.com/content/64/1/25.abstract AB 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.