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. 2023 Aug 3;10(9):1399-1403.
doi: 10.1002/mdc3.13827. eCollection 2023 Sep.

Assessing the Severity of Cervical Dystonia: Ask the Doctor or Ask the Patient?

Adam C Cotton  1 , Laura Scorr  1 , William McDonald  2 , Cynthia Comella  3 , Joel S Perlmutter  4 , Christopher G Goetz  3 , Joseph Jankovic  5 , Laura Marsh  6 , Stewart Factor  1 , H A Jinnah  1   7
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Assessing the Severity of Cervical Dystonia: Ask the Doctor or Ask the Patient?

Adam C Cotton et al. Mov Disord Clin Pract. .

Abstract

Background: Assessing disease severity can be performed using either clinician-rated scales (CRS) or patient-rated outcome (PRO) tools. These two measures frequently demonstrate poor correlations.

Objectives: To determine if the correlation between a CRS and PRO for motor features of cervical dystonia (CD) improves by accounting for non-motor features.

Methods: Subjects with CD (N = 209) were evaluated using a CRS (Toronto Western Spasmodic Torticollis Rating Scale, TWSTRS) and a PRO (Cervical Dystonia Impact Profile, CDIP-58).

Results: Linear regression revealed a weak correlation between the two measures, even when considering only the motor subscales of each. The strength of this relationship improved with a regression model that included non-motor symptoms of pain, depression, and disability.

Conclusions: These results argue that the results of motor assessments in a PRO for CD cannot be fully appreciated without simultaneous assessment of non-motor co-morbidities. This conclusion might apply to other disorders, especially those with frequent non-motor co-morbidities.

Keywords: anxiety; cervical dystonia; depression; dystonia; patient‐reported outcome measure; rating scale; torticollis.

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