Abstract：
BACKGROUND: Myofascial trigger points (TrPs) are hypersensitive points located in a tight band of muscle that, when palpated, produce not only local pain but also referred (distant) pain. The role of TrPs in patients with cervical dystonia (CD) has not been investigated.
OBJECTIVE: To identify the presence of TrPs in patients with isolated idiopathic CD and their association with pain.
METHODS: Thirty-one patients (74.2% women; age: 61.2 years, SD: 10.1 years) participated. TrPs were explored in the sternocleidomastoid, upper trapezius, splenius capitis, levator scapulae, anterior scalene, suboccipital, and infraspinatus muscles. Clinical features of CD were documented as well as the presence of pain. The severity of dystonia and its consequences were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
RESULTS: The mean number of TrPs for each patient was 12 (SD:3), with no differences between patients with pain (n = 20) and those without pain (n = 11). Active TrPs were only found in patients with pain (mean: 7.5, SD:4). Latent TrPs were found in both groups but were more prevalent (P < 0.001) in patients without pain (mean: 11, SD:3.5) than in those with pain (mean: 5, SD:3.5). The number of active TrPs or latent TrPs was positively associated with the TWSTRS disability subscale and the TWSTRS total score. The number of active, but not latent, TrPs was associated with worse scores on the TWSTRS pain subscale.
CONCLUSIONS: Active TrPs were present in patients with CD reporting pain, while latent TrPs were present in all CD patients, irrespective of their pain status. The numbers of active/latent TrPs were associated with disability. TrPs could act as pain generators in CD and also contribute to the involuntary muscle contractions characteristic of dystonia.
OBJECTIVE: To identify the presence of TrPs in patients with isolated idiopathic CD and their association with pain.
METHODS: Thirty-one patients (74.2% women; age: 61.2 years, SD: 10.1 years) participated. TrPs were explored in the sternocleidomastoid, upper trapezius, splenius capitis, levator scapulae, anterior scalene, suboccipital, and infraspinatus muscles. Clinical features of CD were documented as well as the presence of pain. The severity of dystonia and its consequences were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
RESULTS: The mean number of TrPs for each patient was 12 (SD:3), with no differences between patients with pain (n = 20) and those without pain (n = 11). Active TrPs were only found in patients with pain (mean: 7.5, SD:4). Latent TrPs were found in both groups but were more prevalent (P < 0.001) in patients without pain (mean: 11, SD:3.5) than in those with pain (mean: 5, SD:3.5). The number of active TrPs or latent TrPs was positively associated with the TWSTRS disability subscale and the TWSTRS total score. The number of active, but not latent, TrPs was associated with worse scores on the TWSTRS pain subscale.
CONCLUSIONS: Active TrPs were present in patients with CD reporting pain, while latent TrPs were present in all CD patients, irrespective of their pain status. The numbers of active/latent TrPs were associated with disability. TrPs could act as pain generators in CD and also contribute to the involuntary muscle contractions characteristic of dystonia.
摘要：
背景：肌筋膜触发点（TrP）是位于肌肉紧张带中的超敏感点，触诊时，不仅产生局部疼痛，而且产生（远处）疼痛。尚未研究TrP在宫颈肌张力障碍（CD）患者中的作用。
目的：确定特发性CD患者中TrP的存在及其与疼痛的关系。
方法：31例患者（74.2％为女性；年龄：61.2岁，SD：10.1年）参加。在胸锁乳突中探索了TrP，上斜方肌,脾炎,肩胛骨提肌,前斜角,枕下,和冈下肌.记录了CD的临床特征以及疼痛的存在。使用多伦多西部痉挛性斜颈评定量表（TWSTRS）评估肌张力障碍的严重程度及其后果。
结果：每位患者的TrP平均数量为12（SD：3），疼痛患者（n=20）和无疼痛患者（n=11）之间没有差异。仅在疼痛患者中发现有活性的TrP（平均值：7.5，SD：4）。在两组中均发现潜在TrP，但在无疼痛患者（平均值：11，SD：3.5）中比有疼痛患者（平均值：5，SD：3.5）更普遍（P<0.001）。活动TrP或潜在TrP的数量与TWSTRS残疾分量表和TWSTRS总分呈正相关。活跃的数量，但不是潜在的，TrP与TWSTRS疼痛量表评分较差相关。
结论：在报告疼痛的CD患者中存在活性TrP，虽然潜伏的TrP存在于所有CD患者中，不管他们的疼痛状况如何。活跃/潜在TrP的数量与残疾相关。TrP可以充当CD中的疼痛发生器，也有助于肌张力障碍的非自愿肌肉收缩。
目的：确定特发性CD患者中TrP的存在及其与疼痛的关系。
方法：31例患者（74.2％为女性；年龄：61.2岁，SD：10.1年）参加。在胸锁乳突中探索了TrP，上斜方肌,脾炎,肩胛骨提肌,前斜角,枕下,和冈下肌.记录了CD的临床特征以及疼痛的存在。使用多伦多西部痉挛性斜颈评定量表（TWSTRS）评估肌张力障碍的严重程度及其后果。
结果：每位患者的TrP平均数量为12（SD：3），疼痛患者（n=20）和无疼痛患者（n=11）之间没有差异。仅在疼痛患者中发现有活性的TrP（平均值：7.5，SD：4）。在两组中均发现潜在TrP，但在无疼痛患者（平均值：11，SD：3.5）中比有疼痛患者（平均值：5，SD：3.5）更普遍（P<0.001）。活动TrP或潜在TrP的数量与TWSTRS残疾分量表和TWSTRS总分呈正相关。活跃的数量，但不是潜在的，TrP与TWSTRS疼痛量表评分较差相关。
结论：在报告疼痛的CD患者中存在活性TrP，虽然潜伏的TrP存在于所有CD患者中，不管他们的疼痛状况如何。活跃/潜在TrP的数量与残疾相关。TrP可以充当CD中的疼痛发生器，也有助于肌张力障碍的非自愿肌肉收缩。
