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Updated: Jan 14, 2026

Measurement & Analysis of the Temporal Discrimination Threshold Applied to Cervical Dystonia
Published on: January 27, 2018
Investigating Sleep Concerns in Cervical Dystonia
Abhimanyu Mahajan1, David Andrés González2, Cynthia Comella2
1James J. and Joan A. Gardner Family Center For Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA.
Background:
Heterogenous, small cohorts, and co-occurrence of pain and psychiatric burden complicate understanding of sleep in dystonia.
Objective:
To investigate sleep concerns in cervical dystonia (CD).
Methods:
Longitudinal data from CD-PROBE on subjects who were toxin-naïve, new to practice, or without injections for at least 16 weeks were analyzed. Cervical Dystonia Impact Profile captured sleep disturbances. Impact of OnabotulinumtoxinA on sleep was assessed using multilevel mixed models, controlling for demographics, dystonia severity, mood, and pain.
Results:
56% (n = 1037) reported concerns with sleep initiation, restfulness, maintenance, and total time. Initial injection led to a clear improvement in sleep. (P < 0.001) Motor severity (β: 0.20, P < 0.001), mood (β: 0.36, P < 0.001), and pain (β: 0.58, P < 0.001) predicted sleep improvement (n = 502) over three OnabotulinumtoxinA cycles.
Conclusions:
Sleep concerns are common in CD, with initial and subsequent improvement with OnabotulinumtoxinA. Impact of mood and pain on sleep highlights the importance of non-motor features.
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