Cognition and Affect in Cervical Dystonia Patients Without Tremor

1
Cognition and Affect in Cervical
DystoniaPatients Without Tremor
K. Vermilion, J. Peterson, D. Duane Arizona
Dystonia Institute / Arizona State
UniversityScottsdale / Tempe, Arizona, U.S.A.
Objective To assess family history of movement
disorder and mood disorder aswell as personal
qualities of cognition and affect in a referral
population of cervical dystonia patients without
tremor (CD/no T). Methods 165 CD/no T patients
(71 female, 29 CD plus another dystonia site
CD), mean age at evaluation 53 years, mean
duration of CD symptoms 8 years were analyzed
for family history psychiatric disorder (DSM IV
criterion referenced, first degree relatives),
movement disorder (demonstrated manifestations
and seen by patient) T scores gt68 on Minnesota
Multiphasic Personality Inventory (MMPI),
Hamilton Depression Scale (Ham-D) Score gt15,
Spielberger Anxiety Scale Score (Spiel-Anx) gt40
neuropsychological test scores age-adjusted lt15
percentile Rey Auditory Verbal Learning Test
(AVLT), Three Letter Cancellation Task (LCT),
Digit Span (DS), Rey-Osterrieth Complex Figure
(ROCF), Conners Continuous Performance Test
(CPT), Test of Variables of Attention (TOVA) and
Wisconsin Card Sorting Test (WCST). Results
Family history anxiety 15 (9), depression 58
(35), obsessive compulsive disorder 16 (10),
alcohol abuse 55 (33), psychosis 9 (5) non-PD
tremor 50 (36), dystonia 16 (10), scoliosis 27
(16), Parkinson's disease 17 (10). Personal
affective state anxiety 84 (51), depression
103 (62). Impaired cognition verbal learning
(AVLT) 19 of 138 (14), verbal memory (AVLT) 15
of 138 (11), auditory digital memory (DS) 11 of
80 (12), visual vigilance (LCT) 87 of 135 (64),
visual spatial memory (ROCF) 19 of 126 (15),
visual attention (TOVA/CPT) 7 of 18 (39),
executive function (WCST) 25 of 35 (69).
Conclusions Like CD/T (Vermilion, Johnson,
Duane, Mov Disord, 2002), CD/no T patients have a
high rate of family history of dystonia and
scoliosis but not quite as high a rate of family
history of tremor, but when present, like CD/T,
tends to be of the head. Anxiety and depression
are prevalent in both patients and their
relatives. Cognitive deficits are most prevalent
in tasks of vigilance and executive function.
These deficits may reflect dysfunction in basal
ganglion to frontal cortex systems impaired by
the pathophysiology of dystonia.Poster
presentation, 7th International Congress on
Parkinson's Disease and Movement Disorders,
November 13, 2002, Miami, Florida. Vermilion K,
Peterson J, Duane D. Cognition and Affect in
Cervical Dystonia Patients Without Tremor. Mov
Disord, 2002 17 (in press).