虽然特发性肌张力障碍的运动和精神表型越来越被人们所了解,一些研究已经检查了这个比率,type,肌张力障碍其他临床合并症的时间模式。这里,我们确定13个广泛的基于系统的诊断组的临床诊断率,比较整个特发性肌张力障碍队列,和子宫颈肌张力障碍的亚组,眼睑痉挛,和张力障碍震颤,匹配的对照组。使用SAIL数据库,我们进行了一项基于人群的纵向队列研究(1994年1月1日至2017年12月31日),使用居住在威尔士(英国)的个人的匿名电子医疗记录,通过使用先前验证的算法来识别那些被诊断患有肌张力障碍的人。从初级卫生保健记录中确定临床共病诊断,进一步分析需要10%的患病率阈值。使用这种方法,确定了54,166例肌张力障碍病例以及216,574个匹配的对照。在这个群体中,在20年内,10个主要的ICD-10诊断代码超过了10%的患病率阈值(感染,神经学,呼吸,胃肠,泌尿生殖系统,皮肤病学,肌肉骨骼,循环,肿瘤,和内分泌)。在整个肌张力障碍队列中,肌肉骨骼(AOR:1.89,AHR:1.74),呼吸(AOR:1.84;AHR:1.65),和胃肠道疾病(aOR:1.72;aHR:1.6)在肌张力障碍诊断前后的相关性最强。然而,在子宫颈观察到个体临床合并症关联率的变化,眼睑痉挛,和震颤性肌张力障碍组。这项研究表明,在肌张力障碍诊断前后,特定的合并症临床疾病的发生率均有所提高,在对肌张力障碍患者进行临床评估时应予以考虑,以实现最佳的对症治疗。
While motor and psychiatric phenotypes in idiopathic dystonia are increasingly well understood, a few studies have examined the rate, type, and temporal pattern of other clinical co-morbidities in dystonia. Here, we determine the rates of clinical diagnoses across 13 broad systems-based diagnostic groups, comparing an overall idiopathic dystonia cohort, and sub-cohorts of cervical dystonia, blepharospasm, and dystonic tremor, to a matched-control cohort. Using the SAIL databank, we undertook a longitudinal population-based cohort
study (January 1st 1994-December 31st 2017) using anonymised electronic healthcare records for individuals living in Wales (UK), identifying those diagnosed with dystonia through use of a previously validated algorithm. Clinical co-morbid diagnoses were identified from primary health care records, with a 10% prevalence threshold required for onward analysis. Using this approach, 54,166 dystonia cases were identified together with 216,574 matched controls. Within this cohort, ten of the main ICD-10 diagnostic codes exceeded the 10% prevalence threshold over the 20-year period (infection, neurological, respiratory, gastrointestinal, genitourinary, dermatological, musculoskeletal, circulatory, neoplastic, and endocrinological). In the overall dystonia cohort, musculoskeletal (aOR: 1.89, aHR: 1.74), respiratory (aOR: 1.84; aHR: 1.65), and gastrointestinal (aOR: 1.72; aHR: 1.6) disorders had the strongest associations both pre- and post-dystonia diagnosis. However, variation in the rate of association of individual clinical co-morbidities was observed across the cervical, blepharospasm, and tremor dystonia groups. This
study suggests an increased rate of specific co-morbid clinical disorders both pre- and post-dystonia diagnosis which should be considered during clinical assessment of those with dystonia to enable optimum symptomatic management.