Motor and Sensory Features of Cervical Dystonia Subtypes: Data From the Italian Dystonia Registry

none42noIntroduction: Cervical dystonia (CD) is one of the most common forms of adult-onset isolated dystonia. Recently, CD has been classified according to the site of onset and spread, in different clinical subgroups, that may represent different clinical entities or pathophysiologic subtypes. In order to support this hypothesis, in this study we have evaluated whether different subgroups of CD, that clinically differ for site of onset and spread, also imply different sensorimotor features. Methods: Clinical and demographic data from 842 patients with CD from the Italian Dystonia Registry were examined. Motor features (head tremor and tremor elsewhere) and sensory features (sensory trick and neck pain) were investigated. We analyzed possible associations between motor and sensory features in CD subgroups [focal neck onset, no spread (FNO-NS); focal neck onset, segmental spread (FNO-SS); focal onset elsewhere with segmental spread to neck (FOE-SS); segmental neck involvement without spread (SNI)]. Results: In FNO-NS, FOE-SS, and SNI subgroups, head tremor was associated with the presence of tremor elsewhere. Sensory trick was associated with pain in patients with FNO-NS and with head tremor in patients with FNO-SS. Conclusion: The frequent association between head tremor and tremor elsewhere may suggest a common pathophysiological mechanism. Two mechanisms may be hypothesized for sensory trick: a gating mechanism attempting to reduce pain and a sensorimotor mechanism attempting to control tremor.openDi Biasio F.; Marchese R.; Abbruzzese G.; Baldi O.; Esposito M.; Silvestre F.; Tescione G.; Berardelli A.; Fabbrini G.; Ferrazzano G.; Pellicciari R.; Eleopra R.; Devigili G.; Bono F.; Santangelo D.; Bertolasi L.; Altavista M.C.; Moschella V.; Barone P.; Erro R.; Albanese A.; Scaglione C.; Liguori R.; Cotelli M.S.; Cossu G.; Ceravolo R.; Coletti Moja M.; Zibetti M.; Pisani A.; Petracca M.; Tinazzi M.; Maderna L.; Girlanda P.; Magistrelli L.; Misceo S.; Romano M.; Minafra B.; Modugno N.; Aguggia M.; Cassano D.; Defazio G.; Avanzino L.Di Biasio, F.; Marchese, R.; Abbruzzese, G.; Baldi, O.; Esposito, M.; Silvestre, F.; Tescione, G.; Berardelli, A.; Fabbrini, G.; Ferrazzano, G.; Pellicciari, R.; Eleopra, R.; Devigili, G.; Bono, F.; Santangelo, D.; Bertolasi, L.; Altavista, M. C.; Moschella, V.; Barone, P.; Erro, R.; Albanese, A.; Scaglione, C.; Liguori, R.; Cotelli, M. S.; Cossu, G.; Ceravolo, R.; Coletti Moja, M.; Zibetti, M.; Pisani, A.; Petracca, M.; Tinazzi, M.; Maderna, L.; Girlanda, P.; Magistrelli, L.; Misceo, S.; Romano, M.; Minafra, B.; Modugno, N.; Aguggia, M.; Cassano, D.; Defazio, G.; Avanzino, L

Emotional status and fear in patients scheduled for elective surgery during COVID-19 pandemic: a nationwide cross-sectional survey (COVID-SURGERY)

Background Fragmented data exist on the emotional and psychological distress generated by hospital admission during the pandemic in specific populations of patients, and no data exists on patients scheduled for surgery. The aim of this multicentre nationwide prospective cross-sectional survey was to evaluate the impact of pandemic on emotional status and fear of SARS-CoV-2 contagion in a cohort of elective surgical patients in Italy, scheduled for surgery during the COVID-19 pandemic. Results Twenty-nine Italian centres were involved in the study, for a total of 2376 patients surveyed (mean age of 58 years ± 16.61; 49.6% males). The survey consisted of 28 total closed questions, including four study outcome questions. More than half of patients had at least one chronic disease (54%), among which cardiovascular diseases were the commonest (58%). The most frequent type of surgery was abdominal (20%), under general anaesthesia (64%). Almost half of the patients (46%) declared to be frightened of going to the hospital for routine checkups; 55% to be afraid of getting SARS-CoV-2 infection during hospitalization and 62% were feared of being hospitalised without seeing family members. Having an oncological disease and other patient-related, centre-related or perioperative factors were independently associated with an increased risk of fear of SARS-CoV-2 infection during hospitalization and of being hospitalised without seeing family members. A previous infection due to SARS-COV-2 was associated with a reduced risk of worse emotional outcomes and fear of SARS-CoV-2 infection during hospitalization. Patients who showed the most emotionally vulnerable profile (e.g. use of sleep-inducing drugs, higher fear of surgery or anaesthesia) were at higher risk of worse emotional status towards the hospitalization during COVID-19 pandemic. Being operated in hospitals with lower surgical volume and with COVID-19 wards was associated with worse emotional status and fear of contagion. Conclusions Additional fear and worse emotional status may be frequent in patients scheduled for elective surgery during COVID-19 pandemic. More than half of the participants to the survey were worried about not being able to receive family visits. Psychological support may be considered for patients at higher risk of psychological distress to improve perioperative wellbeing during the pandemic