Objective: to research clinical features and their gender differences in CD patients

Background: Cervical dystonia (CD) is a movement disorder of nervous system characterizes by violent dystonic contraction of neck muscles and leads to pathological head and neck positions

Method: We observed 120 CD patients.  The main group consisted of 31(25,84%) males and 89 (74,16%) females. The control group included 50 patients with cervical dorsopathy: 16 males (32%) and 34(68%) females. The average age of patients with CD was 54.4 ± 12.4 years.

We have used neurological scales: Scale of Asthenic State by L.D. Malkova, Multidimensional Fatigue Inventory, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Medical Outcomes Study 36-Items Short- Form Health Survey, Visual Analogue Scale of Pain.

Results: The median age of CD debut for males was 40 [29; 53] years, and for females it was 44 [34; 55]. We found gender differences. The most females with torticollis – 56% (p<0.333) consider psychological stress to be the main cause of the disease but the males with torticollis, laterocollis and other variants of CD groups -67%, 47%, 43% (p<0,0079, р<0,0012, р<0,0263) named physical and static load on the cervical spine. The females with torticollis were more likely to experience head and/or hand tremors than the males of the same group (p=0.0044). The Botulinum therapy reduced head tremor in the most females with torticollis (p<0.0148) more than in the males with torticollis. The intensity of pain was higher in the females with laterocollis according to the scale VAS, than in the males with laterocollis (p=0.0128). The females with dystonic hyperkinesia have a significantly higher degree of anxiety (p=0.0023) and depression (p=0.0375), compared to the males according to the HADS scale. The study showed the females with CD had more severe general and physical asthenia (respectively, p=0.0005 and p=0.0105, according to the MFI-20 scale) compared to the males. The observation revealed a poor nighttime sleep quality in the females, compared to the males (p=0.0001, according to the PSQI questionnaire).

Conclusion: It is necessary to consider the gender differences of patients with CD. Females have a higher prevalence of anxiety, depression, general and physical asthenia and poor sleep quality compared to males. It is important to choose an individual management strategy for correction the motor, psychological and other non-motor symptoms of this disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-differences-in-cervical-dystonia-patients/