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Development of the Comprehensive Cervical Dystonia Rating Scale: Methodology.

Cynthia L Comella1, Susan H Fox2, Kailash P Bhatia3

  • 1Rush Medical School, Chicago, Illinois, USA.

Movement Disorders Clinical Practice
|April 19, 2016
PubMed
Summary

A new Comprehensive Cervical Dystonia (CD) Rating scale (CCDRS) was developed and tested. It combines revised TWSTRS-2, new TWSTRS-PSYCH, and CDIP-58 for comprehensive CD assessment.

Keywords:
CDIP-58TWSTRScervical dystoniafocal dystoniarating scale

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Area of Science:

  • Neurology
  • Clinical Assessment Tools
  • Movement Disorders

Background:

  • Cervical dystonia (CD) is a complex movement disorder.
  • Existing rating scales lack comprehensive assessment of CD's full spectrum, including psychiatric features and quality of life.
  • There is a need for a standardized, modular rating scale for CD research and clinical trials.

Purpose of the Study:

  • To develop and present the methodology for the Comprehensive Cervical Dystonia (CD) Rating scale (CCDRS).
  • To establish the clinimetric properties (reliability and validity) of the CCDRS.
  • To provide a comprehensive assessment tool for cervical dystonia.

Main Methods:

  • Revision of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) by expert consensus into TWSTRS-2.
  • Development of a novel psychiatric screening tool (TWSTRS-PSYCH) using a modified Delphi methodology.
  • Integration of the Cervical Dystonia Impact Profile (CDIP-58) for quality of life assessment.
  • Combination of TWSTRS-2, TWSTRS-PSYCH, and CDIP-58 to form the CCDRS.
  • Clinimetric testing for reliability and validity.

Main Results:

  • The Comprehensive Cervical Dystonia (CD) Rating scale (CCDRS) was successfully constructed.
  • The CCDRS integrates severity, pain, psychiatric features, and quality of life in CD.
  • Clinimetric testing demonstrated the reliability and validity of the CCDRS.
  • The scale is designed for modular use to capture the full spectrum of CD.

Conclusions:

  • The CCDRS offers a rigorous and comprehensive assessment tool for cervical dystonia.
  • This scale is suitable for natural history studies and evaluating novel therapies for CD.
  • The modular design allows for flexible and complete evaluation of CD patients.