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Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study

Grace Bailey Orcid Logo, Anna Rawlings, Fatemeh Torabi Orcid Logo, Owen Pickrell Orcid Logo, Kathryn J. Peall Orcid Logo

Journal of Neurology, Volume: 271, Issue: 6, Pages: 3398 - 3408

Swansea University Authors: Grace Bailey Orcid Logo, Anna Rawlings, Fatemeh Torabi Orcid Logo, Owen Pickrell Orcid Logo

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DOI (Published version): 10.1007/s00415-024-12284-6

Abstract

While motor and psychiatric phenotypes in idiopathic dystonia are increasingly well understood, a few studies have examined the rate, type, and temporal pattern of other clinical co-morbidities in dystonia. Here, we determine the rates of clinical diagnoses across 13 broad systems-based diagnostic g...

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Published in: Journal of Neurology
ISSN: 0340-5354 1432-1459
Published: Springer Science and Business Media LLC 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa67651
Abstract: While motor and psychiatric phenotypes in idiopathic dystonia are increasingly well understood, a few studies have examined the rate, type, and temporal pattern of other clinical co-morbidities in dystonia. Here, we determine the rates of clinical diagnoses across 13 broad systems-based diagnostic groups, comparing an overall idiopathic dystonia cohort, and sub-cohorts of cervical dystonia, blepharospasm, and dystonic tremor, to a matched-control cohort. Using the SAIL databank, we undertook a longitudinal population-based cohort study (January 1st 1994–December 31st 2017) using anonymised electronic healthcare records for individuals living in Wales (UK), identifying those diagnosed with dystonia through use of a previously validated algorithm. Clinical co-morbid diagnoses were identified from primary health care records, with a 10% prevalence threshold required for onward analysis. Using this approach, 54,166 dystonia cases were identified together with 216,574 matched controls. Within this cohort, ten of the main ICD-10 diagnostic codes exceeded the 10% prevalence threshold over the 20-year period (infection, neurological, respiratory, gastrointestinal, genitourinary, dermatological, musculoskeletal, circulatory, neoplastic, and endocrinological). In the overall dystonia cohort, musculoskeletal (aOR: 1.89, aHR: 1.74), respiratory (aOR: 1.84; aHR: 1.65), and gastrointestinal (aOR: 1.72; aHR: 1.6) disorders had the strongest associations both pre- and post-dystonia diagnosis. However, variation in the rate of association of individual clinical co-morbidities was observed across the cervical, blepharospasm, and tremor dystonia groups. This study suggests an increased rate of specific co-morbid clinical disorders both pre- and post-dystonia diagnosis which should be considered during clinical assessment of those with dystonia to enable optimum symptomatic management.
Keywords: Dystonia; Co-morbidity; Epidemiology; Linked clinical data
College: Faculty of Medicine, Health and Life Sciences
Funders: GAB was funded by a KESS2, European Social Fund and Cardiff University PhD Studentship. FT is funded by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. WOP is funded by the Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit Infrastructure Award (Grant No. UA05). The BRAIN Unit is funded by Welsh Government through Health and Care Research Wales. KJP is funded by an MRC Clinician-Scientist Fellowship (MR/P008593/1) and an MRC Transition Fellowship (MR/V036084/1).
Issue: 6
Start Page: 3398
End Page: 3408

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