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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
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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&#x2013;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.</abstract><type>Journal Article</type><journal>Journal of Neurology</journal><volume>271</volume><journalNumber>6</journalNumber><paginationStart>3398</paginationStart><paginationEnd>3408</paginationEnd><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0340-5354</issnPrint><issnElectronic>1432-1459</issnElectronic><keywords>Dystonia; Co-morbidity; Epidemiology; Linked clinical data</keywords><publishedDay>1</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-06-01</publishedDate><doi>10.1007/s00415-024-12284-6</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>GAB was funded by a KESS2, European Social Fund and Cardiff University PhD Studentship. 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spelling 2024-10-25T11:01:17.4985137 v2 67651 2024-09-11 Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study 1e09a407fca9e8047e7738b18d381130 0000-0003-4646-3134 Grace Bailey Grace Bailey true false f4f5ea10d85950ed97dc305ee31b2b22 Anna Rawlings Anna Rawlings true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2024-09-11 MEDS 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. Journal Article Journal of Neurology 271 6 3398 3408 Springer Science and Business Media LLC 0340-5354 1432-1459 Dystonia; Co-morbidity; Epidemiology; Linked clinical data 1 6 2024 2024-06-01 10.1007/s00415-024-12284-6 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee 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). 2024-10-25T11:01:17.4985137 2024-09-11T12:13:13.5524953 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Grace Bailey 0000-0003-4646-3134 1 Anna Rawlings 2 Fatemeh Torabi 0000-0002-5853-4625 3 Owen Pickrell 0000-0003-4396-5657 4 Kathryn J. Peall 0000-0003-4749-4944 5 67651__32714__e105910be4ec495d810e838247cee0d0.pdf 67651.VoR.pdf 2024-10-25T11:00:05.4770268 Output 732235 application/pdf Version of Record true © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
spellingShingle Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
Grace Bailey
Anna Rawlings
Fatemeh Torabi
Owen Pickrell
title_short Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
title_full Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
title_fullStr Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
title_full_unstemmed Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
title_sort Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study
author_id_str_mv 1e09a407fca9e8047e7738b18d381130
f4f5ea10d85950ed97dc305ee31b2b22
f569591e1bfb0e405b8091f99fec45d3
1c3044b5ff7a6552ff5e8c9e3901c807
author_id_fullname_str_mv 1e09a407fca9e8047e7738b18d381130_***_Grace Bailey
f4f5ea10d85950ed97dc305ee31b2b22_***_Anna Rawlings
f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi
1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell
author Grace Bailey
Anna Rawlings
Fatemeh Torabi
Owen Pickrell
author2 Grace Bailey
Anna Rawlings
Fatemeh Torabi
Owen Pickrell
Kathryn J. Peall
format Journal article
container_title Journal of Neurology
container_volume 271
container_issue 6
container_start_page 3398
publishDate 2024
institution Swansea University
issn 0340-5354
1432-1459
doi_str_mv 10.1007/s00415-024-12284-6
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description 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.
published_date 2024-06-01T20:34:17Z
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