{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:10:56Z","timestamp":1792782656567,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Inge-Diesbach-Stiftung"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The prevalence of dystonia has been studied since the 1980s. Due to different methodologies and due to varying degrees of awareness, resulting figures have been extremely different. We wanted to determine the prevalence of dystonia according to its current definition, using quality-approved registries and based on its relevance for patients, their therapy and the health care system. We applied a service-based chart review design with the City of Hannover as reference area and a population of 525,731. Barrier-free comprehensive dystonia treatment in few highly specialised centres for the last 30\u00a0years should have generated maximal dystonia awareness, a minimum of unreported cases and a high degree of data homogeneity. Prevalence [\n                    <jats:italic>n<\/jats:italic>\n                    \/1mio] and relative frequency is 601.1 (100%) for all forms of dystonia, 251.1 (42%) for cervical dystonia, 87.5 (15%) for blepharospasm, 55.2 (9%) for writer\u2019s cramp, 38.0 (6%) for tardive dystonia, 32.3 (5%) for musician\u2019s dystonia, 28.5 (5%) for psychogenic dystonia, 26.6 (4%) for generalised dystonia, 24.7 (4%) for spasmodic dysphonia, 20.9 (3%) for segmental dystonia, 15.2 (3%) for arm dystonia and 13.3 (2%) for oromandibular dystonia. Leg dystonia, hemidystonia and complex regional pain syndrome-associated dystonia are very rare. Compared to previous meta-analytical data, primary or isolated dystonia is 3.3 times more frequent in our study. When all forms of dystonia including psychogenic, generalised, tardive and other symptomatic dystonias are considered, our dystonia prevalence is 3.7 times higher than believed before. The real prevalence is likely to be even higher. Having based our study on treatment necessity, our data will allow better allocation of resources for comprehensive dystonia treatment.\n                  <\/jats:p>","DOI":"10.1007\/s00415-022-11310-9","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T23:22:13Z","timestamp":1660173733000},"page":"6483-6493","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["The epidemiology of dystonia: the Hannover epidemiology study"],"prefix":"10.1007","volume":"269","author":[{"given":"Dirk","family":"Dressler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eckart","family":"Altenm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Giess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim K.","family":"Krauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshte","family":"Adib Saberi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"11310_CR1","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1002\/mds.25475","volume":"28","author":"A Albanese","year":"2013","unstructured":"Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VSC, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK (2013) Phenomenology and classification of dystonia: a consensus update. Mov Disord 28:863\u2013873","journal-title":"Mov Disord"},{"key":"11310_CR2","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/S0749-0712(03)00043-X","volume":"19","author":"E Altenm\u00fcller","year":"2003","unstructured":"Altenm\u00fcller E (2003) Focal dystonia: advances in brain imaging and understanding of fine motor control in musicians. Hand Clin 19:523\u2013538","journal-title":"Hand Clin"},{"key":"11310_CR3","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1016\/S1474-4422(04)00907-X","volume":"3","author":"G Defazio","year":"2002","unstructured":"Defazio G, Abbruzzese G, Livrea P, Berardelli A (2002) Epidemiology of primary dystonia. Lancet Neurol 3:673\u2013678","journal-title":"Lancet Neurol"},{"key":"11310_CR4","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00702-015-1453-x","volume":"123","author":"D Dressler","year":"2016","unstructured":"Dressler D, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, Chung TM, Frucht S, Garcia-Ruiz PJ, Kaelin A, Kaji R, Kanovsky P, Laskawi R, Micheli F, Orlova O, Relja M, Rosales R, Slawek J, Timerbaeva S, Warner TT, Adib Saberi F (2016) Strategies for treatment of dystonia. J Neural Transm 123:251\u2013258","journal-title":"J Neural Transm"},{"key":"11310_CR5","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1007\/s00415-018-8759-1","volume":"265","author":"D Dressler","year":"2018","unstructured":"Dressler D, Bhidayasiri R, Boholega S, Chana P, Chien S, Chung TM, Colosimo C, Ebke M, Fedoroff K, Frank B, Kaji R, Kanovsky P, Ko\u00e7er S, Micheli F, Orlova O, Paus S, Pirtosek Z, Relja M, Rosales RL, Sag\u00e1stegui-Rodr\u00edguez JA, Schoenle PW, Shahidi GA, Timerbaeva S, Walter U, Adib Saberi F (2018) Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy. J Neurol 265:856\u2013862","journal-title":"J Neurol"},{"key":"11310_CR6","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/mds.870090104","volume":"9","author":"D Dressler","year":"1994","unstructured":"Dressler D, Thompson PD, Gledhill RF, Marsden CD (1994) The syndrome of painful legs and moving toes. Mov Disord 9:13\u201321","journal-title":"Mov Disord"},{"key":"11310_CR7","first-page":"27","volume-title":"Treatment of dystonia","author":"B Elibol","year":"2016","unstructured":"Elibol B, Cakmakli Y (2016) Epidemiology of dystonia. In: Dressler D, Altenm\u00fcller E, Krauss JK (eds) Treatment of dystonia. Cambridge University Press, Cambridge, pp 27\u201331"},{"key":"11310_CR8","first-page":"1","volume-title":"Treatmnent of dystonia","author":"S Fahn","year":"2018","unstructured":"Fahn S (2018) Development of the concept of dystonia as a disease, a syndrome and a movement phenomenology. In: Dressler D, Altenm\u00fcller E, Krauss JK (eds) Treatmnent of dystonia. Cambridge University Press, Cambridge, pp 1\u20135"},{"key":"11310_CR9","first-page":"332","volume-title":"Movement disorders","author":"S Fahn","year":"1987","unstructured":"Fahn S, Marsden CD, Calne DB (1987) Classification and investigation of dystonia. In: Marsden CD, Fahn S (eds) Movement disorders, vol 2. 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Eur J Neurol 24:73\u201381","journal-title":"Eur J Neurol"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-022-11310-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-022-11310-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-022-11310-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T08:06:05Z","timestamp":1667117165000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-022-11310-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,11]]},"references-count":13,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["11310"],"URL":"https:\/\/doi.org\/10.1007\/s00415-022-11310-9","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,11]]},"assertion":[{"value":"18 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"DD received honoraria for services provided to Allergan, Ipsen, Merz, Lanzhou Institute of Biological Products, Medy-Tox, Revance, Desitin, Syntaxin, AbbVie, Medtronic, St Jude, Boston Scientific, Almirall, Bayer, Sun, Teva, UCB, IAB\u2014Interdisciplinary Working Group for Movement Disorders. He is shareholder of Allergan and holds patents on botulinum toxin and botulinum toxin therapy. FAS is founder and owner of IAB\u2014Interdisciplinary Working Group for Movement Disorders. She received reimbursement from Abbot, AbbVie, Almirall, Allergan, Bayer, Desitin, Dynamed, Hempel GesundheitsPartner, Ipsen, Johnson & Johnson, Licher, Meda, Medtronic, Merz, Orion, PTZ Nawrath, Sensomotorik & Rehabilitation Hellmuth & Thiel, Sintetica, Sporlastic, Sun, Teva, Tricumed, TRS Med, UCB. RG has nothing to disclose. EA has nothing to disclose. JKK is a consultant to Medtronic and to Boston Scientific. His research is supported by Deutsche Forschungsgemeinschaft (Project #201925000).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was performed under the regulations of the local ethical committee of Hannover Medical School.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}