{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:48:05Z","timestamp":1785322085735,"version":"3.55.0"},"reference-count":62,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary dystonia is conventionally considered as a motor disorder, though an emerging literature reports associated cognitive dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Here, we conducted meta\u2010analyses on studies comparing clinical measures of cognition in persons with primary dystonia and healthy controls (HCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Embase, Cochrane Library, Scopus, and PsycINFO (January 2000\u2013October 2020). Analyses were modeled under random effects. We used Hedge's <jats:italic>g<\/jats:italic> as a bias\u2010corrected estimate of effect size, where negative values indicate lower performance in dystonia versus controls. Between\u2010study heterogeneity and bias were primarily assessed with Cochran's <jats:italic>Q<\/jats:italic>, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>, and Egger's regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 866 initial results, 20 studies met criteria for analysis (dystonia <jats:italic>n<\/jats:italic>\u2009=\u2009739, controls <jats:italic>n<\/jats:italic>\u2009=\u2009643; 254 effect sizes extracted). Meta\u2010analysis showed a significant combined effect size of primary dystonia across all studies (<jats:italic>g<\/jats:italic>\u2009=\u2009\u22120.56, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), with low heterogeneity (<jats:italic>Q<\/jats:italic>\u2009=\u200925.26, <jats:italic>P<\/jats:italic>\u2009=\u20090.15, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0= \u200924.78). Within\u2010domain effects of primary dystonia were motor speed\u2009=\u2009\u22120.84, nonmotor speed\u2009=\u2009\u22120.83, global cognition\u2009=\u2009\u22120.65, language\u2009=\u2009\u22120.54, executive functioning\u2009= \u22120.53, learning\/memory\u2009=\u2009\u22120.46, visuospatial\/construction\u2009=\u2009\u22120.44, and simple\/complex attention = \u22120.37 (<jats:italic>P<\/jats:italic>\u2010values &lt;0.01). High heterogeneity was observed in the motor\/nonmotor speed and learning\/memory domains. There was no evidence of publication bias. Moderator analyses were mostly negative but possibly underpowered. Blepharospasm samples showed worse performance than other focal\/cervical dystonias. Those with inherited (ie, genetic) disease etiology demonstrated worse performance than acquired.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dystonia patients consistently demonstrated lower performances on neuropsychological tests versus HCs. Effect sizes were generally moderate in strength, clustering around \u22120.50 <jats:italic>SD<\/jats:italic> units. Within the speed domain, results suggested cognitive slowing beyond effects from motor symptoms. Overall, findings indicate dystonia patients experience multidomain cognitive difficulties, as detected by neuropsychological tests. \u00a9 2022 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29022","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T07:47:48Z","timestamp":1649231268000},"page":"1483-1494","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Neuropsychological Functioning in Primary Dystonia: Updated and Expanded <scp>Multidomain Meta\u2010Analysis<\/scp>"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-3247","authenticated-orcid":false,"given":"Stephen L.","family":"Aita","sequence":"first","affiliation":[{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth College  Hanover New Hampshire USA"},{"name":"Department of Psychiatry Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor A.","family":"Del Bene","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario A.","family":"Marotta","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"},{"name":"Alabama College of Osteopathic Medicine  Dothan Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin H.","family":"Pizer","sequence":"additional","affiliation":[{"name":"Department of Psychology University of South Alabama  Mobile Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanako A.","family":"Hawley","sequence":"additional","affiliation":[{"name":"Department of Psychology University of South Alabama  Mobile Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Niccolai","sequence":"additional","affiliation":[{"name":"Supportive Care Medicine Moffitt Cancer Center  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Gerstenecker","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy C.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivio J.","family":"Clay","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Crowe","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Triebel","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Heersink School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Psychology University of South Alabama  Mobile Alabama 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