{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:41:04Z","timestamp":1782517264680,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T00:00:00Z","timestamp":1699747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TR001456"],"award-info":[{"award-number":["TR001456"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NS116025"],"award-info":[{"award-number":["NS116025"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are several widely used clinical rating scales for documenting the severity and distribution of various types of dystonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The goal of this study was to evaluate the performance of the most commonly used scales in a large group of adults with the most common types of isolated dystonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Global Dystonia Rating Scale (GDRS) and the Burke\u2010Fahn\u2010Marsden Dystonia Rating Scale (BFM) scores were obtained for 3067 participants. Most had focal or segmental dystonia, with smaller numbers of multifocal or generalized dystonia. These scales were also compared for 209 adults with cervical dystonia that had Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores and 210 adults with blepharospasm that had Blepharospasm Severity Scale (BSRS) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were strong correlations between the GDRS and BFM total scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.79) and moderate correlations for their sub scores (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5). Scores for both scales showed positive skew, with an overabundance of low scores. BFM sub\u2010scores were not normally distributed, due to artifacts caused by the provoking factor. Relevant sub\u2010scores of the GDRS and BFM also showed moderate correlations with the TWSTRS (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5) for cervical dystonia and the BSRS (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5) for blepharospasm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The BFM is more widely used than the GDRS, but these results suggest the GDRS may be preferable for focal and segmental dystonias. The overabundance of very low scores for both scales highlights challenges associated with discriminating very mild dystonia from other abnormal movements or variants of normal behavior.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13909","type":"journal-article","created":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T08:01:00Z","timestamp":1698134460000},"page":"1777-1786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["An Empirical Comparison of Commonly Used Universal Rating Scales for Dystonia"],"prefix":"10.1002","volume":"10","author":[{"given":"Deniz","family":"Boz","sequence":"first","affiliation":[{"name":"College of Arts &amp; Sciences Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamze","family":"Kilic\u2010Berkmen","sequence":"additional","affiliation":[{"name":"Department of Neurology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel S.","family":"Perlmutter","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radiology, Neuroscience, Physical Therapy and Occupational Therapy Washington University School of Medicine  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology Washington University  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Neurology at Washington University at St Louis  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Klein","sequence":"additional","affiliation":[{"name":"Institute of Neurogenetics University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"B\u00e4umer","sequence":"additional","affiliation":[{"name":"Institute of Neurogenetics University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"L\u00f6ns","sequence":"additional","affiliation":[{"name":"Institute of Neurogenetics University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne S.","family":"Feuerstein","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhimanyu","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Rush Parkinson's disease and Movement disorders program, Department of Neurological Sciences  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Wagle\u2010Shukla","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Disease, University of Florida Department of Neurology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Malaty","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Disease, University of Florida Department of Neurology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"LeDoux","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Memphis, Memphis, TN, USA; Veracity Neuroscience LLC  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Ondo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Methodist Neurological Institute Houston TX and Weill Cornell Medical School  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Pantelyat","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Frank","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Saunders\u2010Pullman","sequence":"additional","affiliation":[{"name":"Department of Neurology Icahn School of Medicine at Mount Sinai, and Mount Sinai Beth Israel  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.A.","family":"Jinnah","sequence":"additional","affiliation":[{"name":"Department of Neurology Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Department of Human Genetics Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Department of Pediatrics Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25475"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13524"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1212\/CON.0000000000000747","article-title":"The dystonias","volume":"25","author":"Jinnah HA","year":"2019","journal-title":"Continuum"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25579"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10377"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-010-0546-9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-012-0887-7"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13530"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.660909"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26534"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26156"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.05.004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.5334\/tohm.353"},{"key":"e_1_2_7_15_1","first-page":"21","article-title":"The swallowing and voicing characteristics of pharyngeal dystonia: a single case report","volume":"48","author":"Kahn L","year":"2001","journal-title":"S Afr J Commun Disord"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26817"},{"key":"e_1_2_7_17_1","first-page":"657","article-title":"Consensus\u2010based attributes for identifying patients with spasmodic dysphonia and other voice disorders. JAMA","volume":"144","author":"Ludlow CL","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-321794"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28223"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2009.05.003"},{"key":"e_1_2_7_21_1","article-title":"Mirror movements in movement disorders: a review","volume":"2","author":"Cox BC","year":"2012","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12339"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.736115"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.35.1.73"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2022.120319"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13376"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/dyst.2023.11305"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:14:53Z","timestamp":1760962493000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,12]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/mdc3.13909"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13909","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,12]]},"assertion":[{"value":"2023-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}