Pridinol treatment in cervical dystonia: improvement of non-motor symptoms

Background: Pridinol mesylate is an anticholinergic medication licensed for the treatment of cervical dystonia (CD) in Germany. We intended to assess the drug’s efficacy on motor and non-motor symptoms in CD-patients.Methods This non-interventional pilot study enrolled 20 CD-patients. Pridinol mesylate was prescribed additionally to the standard botulinum toxin (BoNT)-treatment at the initial visit (V1). Follow-up visits were performed after 4 (V2) and after 12 weeks (V3). Motor and non-motor symptoms were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), the Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest), the Beck Depression Inventory (BDI-II), and the EQ-5D-5L Quality of Life assessment.Results The TWSTRS part I motor score and BDI-II significantly improved from V1 to V3. The TWSTRS part III (pain) showed some effect between V1 and V2 and remained unchanged until V3. There was a significant negative correlation between the visual analog scale of the EQ-5D-5L and TWSTRS and a trend towards a positive correlation between TWSTRS part III and BDI-II.Discussion Our findings suggest, that pridinol mesylate has some additional clinical effect on motor symptoms and pain when added to BoNT-treatment.