{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:37:59Z","timestamp":1790008679701,"version":"4.0.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whether the traditional distinction between segmental and multifocal dystonia is clinically or scientifically useful remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether idiopathic isolated adult\u2010onset segmental and multifocal dystonia can be differentiated based on clinical features other than the contiguity of affected body regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared data on segmental and multifocal dystonia from two large dystonia databases established in the USA and Italy that used similar criteria for patient recruitment and assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to segmental dystonia, multifocal dystonia was characterized by a higher proportion of men, a younger age at dystonia onset, a greater frequency of upper limb dystonia, and a lower frequency of cranial dystonia at both onset and last examination. Segmental and multifocal dystonia had a similar frequency of alleviating maneuvers, non\u2010motor eye symptoms in blepharospasm, and neck pain and tremor in cervical dystonia. Although the initial spread pattern from focal to segmental or multifocal appeared faster in the segmental dystonia group, adjusting the analysis for the initial body site involved revealed no significant differences between the two groups. Segmental and multifocal dystonia starting in the same body site showed similar age, sex, and spread characteristics. The observed differences and similarities were consistent across both independent databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Segmental and multifocal dystonia share differences and similarities. The observed differences may reflect a difference in the predominant site of dystonia onset. From a clinical perspective, therefore, the segmental\/multifocal distinction is probably not valuable in the dystonia classification scheme, although further data may be needed from a pathophysiological perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70390","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:36:39Z","timestamp":1760168199000},"page":"748-756","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Segmental and Multifocal Isolated Dystonias: Similarities and Differences"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1531-3969","authenticated-orcid":false,"given":"Hyder A.","family":"Jinnah","sequence":"first","affiliation":[{"name":"Department of Neurology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9040-4884","authenticated-orcid":false,"given":"Vittorio","family":"Velucci","sequence":"additional","affiliation":[{"name":"Department of Translational Biomedicine and Neuroscience University of Bari Aldo Moro  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4485-2200","authenticated-orcid":false,"given":"Daniele","family":"Belvisi","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University of Rome  Rome Italy"},{"name":"IRCCS Neuromed Institute  Pozzilli Italy"}],"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":"Laura J.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Klein","sequence":"additional","affiliation":[{"name":"Institute of Neurogenetics University of Luebeck  Luebeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7701-3120","authenticated-orcid":false,"given":"Jeanne S.","family":"Feuerstein","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Colorado School of Medicine  Aurora Colorado USA"},{"name":"Department of Neurology, Rocky Mountain Regional VA Medical Center  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Bellows","sequence":"additional","affiliation":[{"name":"Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Jankovic","sequence":"additional","affiliation":[{"name":"Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Comella","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Barbano","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Wagle Shukla","sequence":"additional","affiliation":[{"name":"Department of Neurology, Norman Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen G.","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"LeDoux","sequence":"additional","affiliation":[{"name":"Veracity Neuroscience  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-136X","authenticated-orcid":false,"given":"Alberto J.","family":"Espay","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin R.","family":"Duque","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence C.F.","family":"Chang","sequence":"additional","affiliation":[{"name":"Movement Disorders Unit, Department of Neurology, Westmead Hospital  Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3085-2282","authenticated-orcid":false,"given":"Victor S.C.","family":"Fung","sequence":"additional","affiliation":[{"name":"Movement Disorders Unit, Department of Neurology, Westmead Hospital  Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Sydney New South Wales 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