Mood disorder affects age at onset of adult-onset cervical dystonia

Abstract

Introduction: Mood disorder is common in cervical dystonia, affects quality of life and may precede the onset of the dystonia. There is controversy as to whether mood disorder is part of the primary process or secondary to the disability.We assessed the characteristics of cervical dystonia patients in relation to a past history of mood disorder.

Methods: At a University Hospital clinic, in all consenting patients with cervical dystonia, we uniformly collected demographic data, medical history, and prospectively, measures of prevalent mood disorder.

Results: In 193 patients (128 women and 65 men) mean age at onset was 43.9 years and mean duration of cervical dystonia was 17.5 years. Men had earlier age at onset of cervical dystonia than women (p = 0.0037). A history of a mood disorder was reported in 53/128 (41%) women with a significantly earlier median age at onset of cervical dystonia (42 years) than 75/128 (59%) women with no history of mood disorder (48 years) (p = 0.005); 33 (26%) women with mood disorder prior to dystonia also had an earlier age at onset of dystonia than the 75 without such a history (p = 0.0154). A history of mood disorder was more common in women (41%) than men (31%); 54/128 (42%) women and 21/65 (32%) men had current mood disorder symptoms.

Conclusions: In our cervical dystonia clinic population significant differences in the age at onset in women with, and without, a history of mood disorder strongly indicates that anxiety and depression are primary non-motor (and premotor) symptoms of cervical dystonia.

Keywords: Age at onset; Anxiety; Cervical dystonia; Depression; Sex.

Fig. 1

Cumulative percentage affected by age at onset of cervical dystonia for 65/193 men (blue squares and connecting lines) and 128/193 women (red circles and connecting line). The 65 men had median age at onset of CD of 41 years; the 128 women had median age at onset of CD of 46 years (P = 0.0037; Mann-Whitney; see Table 1).

Fig. 2

Cumulative percentage affected by age at onset of cervical dystonia for 53/128 women with a history of mood disorder (blue triangles and connecting line) and 75/128 women with no history of a mood disorder (red circles and connecting line). The 53 women with mood disorder history had a median age at onset of CD of 42 years; the 75 women with no such history had a median age at onset of CD of 48 years (p = 0.005; Mann-Whitney; see Table 1).