Static Graviceptive Functions in Patients With Cervical Dystonia (CD)

NCT ID: NCT01180270

Last Updated: 2012-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

45 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-06-30

Study Completion Date

2012-01-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this experimental pilot study is to test the effect of normalization of the head position on the sense of balance at patients with cervical dystonia under routine botulinum toxin treatment.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background:

The pathophysiological mechanism of cervical dystonia remains unclear. Affection of static graviceptive function has been shown in these patients by measuring the Subjective Visual Vertical (SVV). Healthy subjects, tested with voluntary head tilt, would tilt SVV in the opposite direction of the head. (Müller "E" effect), whereas patients with cervical dystonia set SVV close to true upright with a minimal deviation toward head-tilt. The mechanism of this change in otolith activity in patients with cervical dystonia is still unknown. When treated with botulinum toxin, head deviation will be reversed during a period of approximate 6-9 weeks, with a first peak of action after approximate 3 weeks.

Aim

The aim of this study is to investigate the effect of normalization of the head position under routine intramuscular botulinum toxin application in the cervical muscles (screening, 3 weeks and 9 weeks after injection) on static graviceptive function in patients with cervical dystonia.

Rationale

To our knowledge, the effect of botulinum toxin therapy on static otolith function in patients with cervical dystonia has never been evaluated. This study may provide new informations on the neural plasticity of the vestibular system and may contribute to the understanding of pathophysiological mechanisms of cervical dystonia. Accordingly, it may help developing new treatment strategies for this disease.

Primary hypothesis

There is a difference of at least 6 degrees in subjective visual vertical of patients with CD tested in habitual head position at study inclusion and 3 weeks after injection of Botulinum Toxin.

Study design

Subjective visual vertical will be tested in Patients with CD, who are pre-treated with botulinum toxin and show a good treatment response.

Patients SVV will be assessed before routine botulinum toxin injection (on day of injection), 3 and 9 weeks after injection. For control, SVV will be assessed in normal subjects.

SVV assessment

SVV will be performed by the patient and control while sitting upright in a dark room in different head positions, the head is fixed using a head holder.

In CD patients, SVV will be assessed in different head positions:

1. the habitual head deviation (head deviation will be classified by Tsui score),
2. head fixed in neutral head position (defined as 0° or no head rotation).
3. ear deviated 15° and 30° to ipsilateral and contralateral side, respectively, starting at habitual head deviation

SVV in normal subject, with

A) head fixed in neutral position (defined as 0° or no head rotation),

B) ear deviated 30° to the left,

C) ear deviated 30° to the right,

D) ear deviated 15° to the left,

E) ear deviated 15° to the right, will be assessed.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Cervical Dystonia

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Cervical dystonia torticollis spasmodicus botulinum toxin Subjective visual vertical (SVV) SVV static graviceptive function

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cervical dystonia

patients suffering from cervical dystonia

under routine botulinum toxin treatment

No interventions assigned to this group

healthy volunteers

control group

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Idiopathic CD and willing to participate on the study,
* Isolated laterocollis or laterocollis and torticollis with maximum of 15°rotation
* Aged 18-80 years,
* Under routine treatment with botulinum toxin

Exclusion Criteria

Patients and Control

* History of vestibular disorders

Patients

* Torticollis with \>15°rotation
* Secondary CD (structural MRI lesions, Mb. Wilson)
* Contraindication for intramuscular botulinum toxin therapy: bleeding disorder or anticoagulation therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Kirsten Elwischger

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Kirsten Elwischger

MD

Responsibility Role SPONSOR_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Department of neurology, Medical University of Vienna

Vienna, Vienna, Austria

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Austria

References

Explore related publications, articles, or registry entries linked to this study.

Vacherot F, Vaugoyeau M, Mallau S, Soulayrol S, Assaiante C, Azulay JP. Postural control and sensory integration in cervical dystonia. Clin Neurophysiol. 2007 May;118(5):1019-27. doi: 10.1016/j.clinph.2007.01.013. Epub 2007 Mar 23.

Reference Type BACKGROUND
PMID: 17383228 (View on PubMed)

Bove M, Brichetto G, Abbruzzese G, Marchese R, Schieppati M. Neck proprioception and spatial orientation in cervical dystonia. Brain. 2004 Dec;127(Pt 12):2764-78. doi: 10.1093/brain/awh291. Epub 2004 Sep 8.

Reference Type BACKGROUND
PMID: 15355873 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SVV_CD1

Identifier Type: -

Identifier Source: org_study_id