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Set-shifting and behavioral dysfunction in primary focal dystonia

Authors

  • Paulo Bugalho MD,

    Corresponding author
    1. Department of Neurology, Hospital Egas Moniz, Rua da Junqueira, Lisboa, Portugal
    • Department of Neurology, Hospital de Egas Moniz, Rua da Junqueira, 126, 1349-019 Lisboa, Portugal

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  • Bernardo Corrêa MD,

    1. Department of Psychiatry and Mental Health, Hospital São Francisco Xavier, Lisboa, Portugal
    2. Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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  • João Guimarães MD,

    1. Department of Neurology, Hospital Egas Moniz, Rua da Junqueira, Lisboa, Portugal
    2. Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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  • Miguel Xavier PhD

    1. Department of Psychiatry and Mental Health, Hospital São Francisco Xavier, Lisboa, Portugal
    2. Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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Abstract

The occurrence of cognitive and behavioral symptoms in patients with primary dystonia remains a matter of debate. We compared 45 patients with primary dystonia with 27 control subjects for performance on neuropsychological tasks with a load on executive-Wisconsin Card Sorting Test (WCST) and Stroop test, and visuospatial-Benton's visual retention test (BVRT) and Block assembly test from Wechsler Adult Intelligence Scale BAT-functions, as well as for intensity of obsessive-compulsive symptoms (Yale Brown Obsessive Compulsive Scale, Y-BOCS). Correlation analysis was performed between neuropsychological performance, dystonia characteristics (duration, age of onset) and severity (Unified Dystonia Rating Scale, UDRS), and Y-BOCS. Patients made more perseverative errors on the WCST (P = 0.042) and had a higher mean Y-BOCS (P = 0.003) score than controls. Timed tests (BVRT, BAT, Stroop test) correlated with UDRS. Y-BOCS, WCST, and UDRS scores were not significantly correlated with one another.These results suggest that patients with primary dystonia may have set-shifting deficits and a higher intensity of obsessive compulsive symptoms when compared to healthy subjects. This may reflect a pattern of complex neurophysiological dysfunction involving dorsolateral, orbitofrontal, and motor frontostriatal circuits. © 2007 Movement Disorder Society

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