Abstract
BACKGROUND: Sensory tricks (STs) are voluntary maneuvers that dampen the abnormal movement in cervical dystonia (CD). OBJECTIVES: To investigate the effect of ST on CD severity and treatment. METHODS: Data on 1039 individuals with a modified Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score were extracted from the CD Patient Registry for Observation of OnabotulinumtoxinA (onabotA) Efficacy study. Univariate and multivariate models evaluated the direct and indirect impact of ST on CD severity and treatment, while controlling for confounds. RESULTS: Complete ST was associated with a 10% lower mean onabotA dose. Absence of complete ST was associated with a higher onabotA dose after controlling for dystonia severity (OR = 1.37, P = 0.04). ST moderated the relationship between dystonia severity and toxin dose (β = -0.16, P = 0.02). CONCLUSIONS: ST is related to lower CD severity and toxin dose. It may have a direct effect on lowering toxin dose, independent of CD severity.