{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:49:28Z","timestamp":1780634968662,"version":"3.54.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T00:00:00Z","timestamp":1705708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T00:00:00Z","timestamp":1705708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neural Transm"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Idiopathic cervical dystonia (ICD) is by far the largest subgroup of dystonia. Still, its natural course is largely unknown. We studied the natural course of 100 ICD patients from our botulinum toxin clinics (age at ICD onset 45.8\u2009\u00b1\u200913.5\u00a0years, female\/male ratio 2.0) over a period of 17.5\u2009\u00b1\u200911.5\u00a0years with follow-ups during botulinum toxin therapy and with semi-structured interviews. Two courses of ICD could be distinguished by symptom development of more or less than 6\u00a0months. ICD-type 2 was less frequent (19% vs 81%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), had a more rapid onset (8.7\u2009\u00b1\u20098.0\u00a0weeks vs 3.8\u2009\u00b1\u20093.5\u00a0years), a higher remission rate (92% vs 5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a higher prevalence of excessive psychological stress preceding ICD (63% vs 1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In both ICD-types, the plateau phase was non-progressive. Significant differences in patient age at ICD onset, latency and extent of remission, female\/male ratio and prevalence of family history of dystonia could not be detected. ICD is a non-progressive disorder. ICD-type 1 represents the standard course. ICD-type 2 features rapid onset, preceding excessive psychological stress and a high remission rate. These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms. They contradict the widespread fear of patients of a constant and continued decline of their condition. Excessive psychological stress may be an epigenetic factor triggering the manifestation of genetically predetermined dystonia.<\/jats:p>","DOI":"10.1007\/s00702-023-02736-0","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T09:02:16Z","timestamp":1705741336000},"page":"245-252","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The natural course of idiopathic cervical dystonia"],"prefix":"10.1007","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3612-3796","authenticated-orcid":false,"given":"Dirk","family":"Dressler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Kopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhen","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshte Adib","family":"Saberi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"key":"2736_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 VS, 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":"2736_CR2","first-page":"451","volume":"25","author":"WV Br\u00e4utigam","year":"1954","unstructured":"Br\u00e4utigam WV (1954) Grundlagen und erscheinungsweisen des torticollis spasticus, verlaufsuntersuchung bei 25 kranken. Nervenarzt 25:451\u2013462","journal-title":"Nervenarzt"},{"key":"2736_CR3","doi-asserted-by":"publisher","first-page":"6483","DOI":"10.1007\/s00415-022-11310-9","volume":"269","author":"D Dressler","year":"2022","unstructured":"Dressler D, Altenm\u00fcller E, Giess R, Krauss JK, Adib Saberi F (2022) The epidemiology of dystonia: the hannover epidemiology study. J Neurol 269:6483\u20136493","journal-title":"J Neurol"},{"key":"2736_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-023-02694-7","author":"D Dressler","year":"2023","unstructured":"Dressler D, Kopp B, Pan L, Adib Saberi F (2023) Excessive psychological stress preceding the onset of idiopathic cervical dystonia. J Neural Transm. https:\/\/doi.org\/10.1007\/s00702-023-02694-7","journal-title":"J Neural Transm"},{"key":"2736_CR5","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1212\/WNL.36.3.398","volume":"36","author":"A Friedman","year":"1986","unstructured":"Friedman A, Fahn S (1986) Spontaneous Remissions in Spasmodic Torticollis. Neurology 36:398\u2013400","journal-title":"Neurology"},{"key":"2736_CR6","doi-asserted-by":"publisher","first-page":"S149","DOI":"10.1016\/j.parkreldis.2015.08.036","volume":"22","author":"M Hallett","year":"2016","unstructured":"Hallett M (2016) Functional (psychogenic) movement disorders\u2014clinical presentations. Parkinsonism Relat Disord 22:S149\u2013S152","journal-title":"Parkinsonism Relat Disord"},{"key":"2736_CR7","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1136\/jnnp.47.11.1236","volume":"47","author":"D Jayne","year":"1984","unstructured":"Jayne D, Lees AJ, Stern GM (1984) Remission in spasmodic torticollis. J Neurol Neurosurg Psychiatr 47:1236\u20131237","journal-title":"J Neurol Neurosurg Psychiatr"},{"key":"2736_CR8","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.1016\/B978-0-444-59565-2.00059-9","volume":"113","author":"C Klein","year":"2013","unstructured":"Klein C, M\u00fcnchau A (2013) Progressive dystonia. Handb Clin Neurol 113:1889\u20131897","journal-title":"Handb Clin Neurol"},{"key":"2736_CR9","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1002\/mds.10301","volume":"18","author":"MS LeDoux","year":"2003","unstructured":"LeDoux MS, Brady KA (2003) Secondary cervical dystonia associated with structural lesions of the central nervous system. Mov Disord 18:60\u201369","journal-title":"Mov Disord"},{"key":"2736_CR10","first-page":"E13","volume":"28","author":"JY Maigne","year":"2003","unstructured":"Maigne JY, Mutschler C, Doursounian L (2003) Acute torticollis in an adolescent. Case Rep MRI Study Spine 28:E13\u2013E15","journal-title":"Case Rep MRI Study Spine"},{"key":"2736_CR11","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S0140-6736(71)92318-X","volume":"298","author":"R Meares","year":"1971","unstructured":"Meares R (1971) Natural history of spasmodic torticollis, and effect of surgery. Lancet 298:149\u2013151","journal-title":"Lancet"},{"key":"2736_CR12","unstructured":"Pana A, Saggu BM (2022) Dystonia. In: StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing (PMID: 28846290)"},{"key":"2736_CR13","first-page":"210","volume":"95","author":"M Van Zandijcke","year":"1995","unstructured":"Van Zandijcke M (1995) Cervical dystonia (spasmodic torticollis). Some aspects of the natural history. Acta Neurol Belg 95:210\u2013215","journal-title":"Acta Neurol Belg"}],"container-title":["Journal of Neural Transmission"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00702-023-02736-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00702-023-02736-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00702-023-02736-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T12:04:37Z","timestamp":1708171477000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00702-023-02736-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,20]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["2736"],"URL":"https:\/\/doi.org\/10.1007\/s00702-023-02736-0","relation":{},"ISSN":["0300-9564","1435-1463"],"issn-type":[{"value":"0300-9564","type":"print"},{"value":"1435-1463","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,20]]},"assertion":[{"value":"19 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dirk Dressler: 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-Interdisciplinary Working Group for Movement Disorders. He is shareholder of Allergan and holds patents on botulinum toxin and botulinum toxin therapy. Bruno Kopp: BK has nothing to declare. Lizhen Pan: LP has nothing to declare. Fereshte Adib Saberi: 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 and Rehabilitation Hellmuth and Thiel, Sintetica, Sporlastic, Sun, Teva, Tricumed, TRS Med, UCB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict 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"}}]}}