{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:55:50Z","timestamp":1791291350422,"version":"4.3.0"},"reference-count":66,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sensory tricks (also termed \u201calleviating maneuvers\u201d) are voluntary maneuvers that transiently alleviate dystonic postures or movements and represent a hallmark clinical feature of dystonia with diagnostic and mechanistic significance. Despite extensive phenomenological description, the evidence base has not been systematically synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize the prevalence, phenomenology, clinical effects, predictors, neurobiological mechanisms, and translational relevance of alleviating maneuvers in dystonia, and to prospectively evaluate the feasibility of quantitative synthesis across predefined outcome domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review with a prespecified nested quantitative synthesis was conducted using a preregistered PROSPERO protocol (CRD420251175065). The nested component was defined a priori as a domain\u2010restricted analytic strategy in which random\u2010effects meta\u2010analysis was planned where \u2265\u00a03 conceptually comparable studies were available, and in which the feasibility of pooling was itself treated as a primary methodological outcome. PubMed, Scopus, and the Cochrane Library were searched from inception. Studies reporting original empirical data on alleviating maneuvers in human dystonia of any etiology were included. Qualitative synthesis examined phenomenology, clinical effects, predictors, mechanisms, and translational applications. Heterogeneity was examined separately along clinical, methodological, and outcome\u2010level dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 631 records, 53 studies met inclusion criteria; 31 contributed to qualitative synthesis and 26 to nested quantitative analyses, with 4 contributing to both. No eligible studies in functional or tardive dystonia were identified. Alleviating maneuvers were reported across dystonia subtypes, with prevalence ranging from 13% to 90%; the largest registry cohort (n = 1477) reported effective maneuvers in 68.7% of patients. Acute motor improvements of 30%\u201350% in head deviation were reported during trick execution, although effects were transient. Responsiveness was associated with shorter disease duration and better response to botulinum toxin. No domain met criteria for formal meta\u2010analysis; structural barriers were predominantly methodological and outcome\u2010level rather than clinical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alleviating maneuvers are a clinically consistent and mechanistically informative feature of dystonia, but their magnitude, durability, and predictors remain inconsistently measured. Standardized paradigms and outcome reporting are required to enable quantitative synthesis and sham\u2010controlled evaluation of device\u2010based alleviating\u2010maneuver analogues.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71575","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:30:51Z","timestamp":1784032251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sensory Tricks in Dystonia: A Systematic Review and Nested Quantitative Synthesis"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-1835","authenticated-orcid":false,"given":"Anish","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Neurology, Ramaiah Medical College and Hospitals Ramaiah University of Applied Sciences  Bengaluru India"},{"name":"Department of Research Placeboes Research Foundation  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6932-2528","authenticated-orcid":false,"given":"Thyagarajan","family":"Shivashanmugam","sequence":"additional","affiliation":[{"name":"Department of Research Placeboes Research Foundation  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6575-424X","authenticated-orcid":false,"given":"Michiko K.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Parkinson's and Movement Disorder Center, The Queen's Medical Center University of Hawai\u02bbi  Honolulu, Hawaii USA"},{"name":"John A. Burns School of Medicine University of Hawai\u02bbi  Honolulu, Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-2064","authenticated-orcid":false,"given":"Roongroj","family":"Bhidayasiri","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-9137","authenticated-orcid":false,"given":"Sanjay","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Medicine Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham  Faridabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8185-286X","authenticated-orcid":false,"given":"Kailash P.","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis C. S.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-2377","authenticated-orcid":false,"given":"Pramod Kumar","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS)  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10327"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25888"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2025.107263"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22374"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.7916\/4q53\u2010vt23"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","unstructured":"Boyd J. 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A.Mahnan andJ.Konczak.2021. \u201cVibro\u2010Tactile Stimulation as a Non\u2010Invasive Neuromodulation Therapy for Cervical Dystonia: A Case Study.\u201d InAnnual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) 6314\u20136317.IEEE.https:\/\/doi.org\/10.1109\/EMBC46164.2021.9629717.","DOI":"10.1109\/EMBC46164.2021.9629717"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/brb3.71575","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:15:33Z","timestamp":1791288933000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.71575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":66,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/brb3.71575"],"URL":"https:\/\/doi.org\/10.1002\/brb3.71575","archive":["Portico"],"relation":{},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71575"}}