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In this viewpoint paper, we argue that the most distinctive aspects of adult onset isolated focal dystonia are the marked sex\u2010related differences demonstrated by epidemiological, clinical, and laboratory studies in patients with adult onset dystonia, particularly in cervical dystonia, the most common presentation. We propose that the future focus of research should be on neurobiological mechanisms underlying the profound sexual dimorphism in this disorder. Targeting research into gamma aminobutyric acid (GABA)ergic function, which also shows similar sexual dimorphism, would be most productive in elucidating the pathogenesis of adult onset dystonia. \u00a9 2021 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.28454","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T12:59:07Z","timestamp":1611752347000},"page":"604-608","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["We Must Talk about Sex and Focal Dystonia"],"prefix":"10.1002","volume":"36","author":[{"given":"Shameer","family":"Rafee","sequence":"first","affiliation":[{"name":"Department of Neurology St. Vincent's University Hospital  Dublin Ireland"},{"name":"School of Medicine and Medical Science University College Dublin  Dublin 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