Attention impairment in patients with cervical dystonia: An attention network test study

Xia, Kun; Han, Yongsheng; Zhou, Lanlan; Hu, Sheng; Rao, Rao; Shan, Shu; Hua, Lei · 2022 · OpenAlex-citations

DOI: 10.3389/fpsyg.2022.952567

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Summary

This study investigates the specific characteristics of attentional network dysfunction in patients with cervical dystonia (CD), a movement disorder characterized by involuntary neck muscle contractions. While previous research indicated general cognitive deficits in CD, the specific profiles of attention networks—alerting, orienting, and executive control—remained unclear. The authors aimed to determine whether CD patients exhibit comprehensive attention deficits or impairments in specific networks, and whether these deficits correlate with disease severity. The researchers recruited 29 CD patients and 26 healthy controls (HCs) matched for age, sex, and education. Participants underwent the Attention Network Test (ANT), which quantifies the efficiency of the three attention networks via reaction time (RT) and accuracy. Clinical severity was assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), and neuropsychological background was evaluated using the Montreal Cognitive Assessment, Hamilton Anxiety Scale, and Hamilton Depression Scale. Statistical analyses included ANOVA for network efficiencies and Spearman correlations to examine relationships between attention scores and clinical variables. Results revealed a significant deficit in the alerting network for CD patients compared to HCs (t = −3.40, p = 0.01), indicating reduced ability to maintain a responsive state and utilize warning cues. In contrast, no significant differences were found between groups in orienting network efficiency (p = 0.79), executive control network efficiency (p = 0.58), total mean RT (p = 0.79), or accuracy (p = 0.09). Correlation analysis showed that alerting network efficiency was significantly negatively correlated with TWSTRS torticollis severity and disability scores, as well as pain scores. Orienting and executive control networks also showed negative correlations with disease severity, though weaker than those for alerting. Attention functions were not correlated with anxiety or depression scores, likely due to low symptom levels in the cohort. The study concludes that CD patients exhibit a specific impairment in the alerting network, while orienting and executive control functions remain intact. This alerting deficit is strongly associated with the severity of torticollis and pain, suggesting potential involvement of norepinephrine systems or chronic pain mechanisms. The findings imply that attention training could be a viable therapeutic adjunct for CD, potentially improving both cognitive and motor outcomes. The authors note limitations regarding sample size and subtype distribution, calling for larger studies to explore subtype-specific differences and the reversibility of these deficits following treatment.

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• attention selective divided