The overall goal of the Dystonia Coalition is to provide strong foundations essential for development of new treatments for the isolated dystonia syndromes, previously known as primary dystonias. These disorders include cervical dystonia (also known as torticollis), blepharospasm and related craniofacial dystonias (sometimes called Meige syndrome), laryngeal dystonia (also known as spasmodic dysphonia), and limb dystonias (e.g., writer's cramp, musician's dystonias, foot dystonia). Also included are various combinations of the isolated dystonias such as segmental and multifocal dystonias, and generalized dystonias affecting much of the body. The lack of knowledge regarding their natural history, the lack of universally accepted diagnostic guidelines, the paucity of universally accepted rating scales to monitor disease progression, and the lack of practical biomarkers and understanding of genetic substrates all have hampered development of new treatments. Rather than address each type of dystonia in separate study protocols, Project 1 has served as a core to centrally collect uniform data elements for all of them, in parallel with a DNA biorepository tht is part of a collaboration with the NINDS Human Genetics Resource at Coriell. Project 1 must be continued because we need additional subjects with the rarest forms of dystonia and because all dystonias evolve very slowly over 3- 20 years making a longer duration of follow-up necessary to obtain a complete picture of the natural history. Projects 2-4 address the development of internationally acceptable and rigorously validated diagnostic criteria and rating tools to measure disease severity for the most common subtypes of dystonia. Project 2 focusing on cervical dystonia and Project 3 focusing on laryngeal dystonia reached recruitment goals during the first funding cycle and final analyses are being completed this year. Project 4 focusing on blepharospasm is introduced here for the new funding cycle. It was modeled after the successful experiences of Projects 2 and 3, with some of the same methods and personnel who conducted Projects 2 and 3. Also during the first funding cycle, we established a Pilot Projects Program and a Career Development (Training) Program, both of which have been very successful and will be continued in the second funding cycle. To facilitate rapid recruitment for all of these projects and to encourage collaboration, the Dystonia Coalition has maintained a unique open-door policy that permits qualified centers to contribute to specific projects according to their special interests and abilities. During its first funding cycle, the Dystonia Coalition's multidisciplinary team started with 14 sites but ultimately engaged 48 sites across North America, Europe, Israel, and Australia. The number of participating Patient Advocacy Groups started at 8 and increased to 17. The scope of collaboration facilitated during our first funding cycle is unprecedented for the dystonia research community, with projects that all provide fundamental tools to enable rigorous clinical trials for desperately needed new treatments.

Public Health Relevance

The overall goal of the Dystonia Coalition is to provide strong foundations essential for development of new treatments for the isolated dystonia syndromes, previously known as 'primary' dystonias. The objectives are to better understand the natural history of these disorders, to develop a biorepository for exploration of biomarkers and genetic determinants, to develop internationally acceptable diagnostic criteria and rating tools for monitoring clinical severity, and to encourage development of new investigators and collaborations. These objectives are fundamental ingredients for the development of clinical trials to establish desperately needed new treatments.

National Institute of Health (NIH)
National Center for Advancing Translational Sciences (NCATS)
Specialized Center--Cooperative Agreements (U54)
Project #
Application #
Study Section
Special Emphasis Panel (ZNS1-SRB-S (62))
Program Officer
Gopal-Srivastava, Rashmi
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Emory University
Schools of Medicine
United States
Zip Code
Jinnah, H A; Hess, Ellen J (2018) Evolving concepts in the pathogenesis of dystonia. Parkinsonism Relat Disord 46 Suppl 1:S62-S65
Cotton, Adam C; Bell, R B; Jinnah, H A (2018) Expert Opinion vs Patient Perspective in Treatment of Rare Disorders: Tooth Removal in Lesch-Nyhan Disease as an Example. JIMD Rep 41:25-27
Jinnah, H A; Comella, Cynthia L; Perlmutter, Joel et al. (2018) Longitudinal studies of botulinum toxin in cervical dystonia: Why do patients discontinue therapy? Toxicon 147:89-95
Jinnah, H A; Albanese, Alberto; Bhatia, Kailash P et al. (2018) Treatable inherited rare movement disorders. Mov Disord 33:21-35
Shi, Lucy L; Simpson, C Blake; Hapner, Edie R et al. (2018) Pharyngeal Dystonia Mimicking Spasmodic Dysphonia. J Voice 32:234-238
Liu, Hui; Jin, Hongjun; Luo, Zonghua et al. (2018) In Vivo Characterization of Two 18F-Labeled PDE10A PET Radioligands in Nonhuman Primate Brains. ACS Chem Neurosci 9:1066-1073
Scorr, Laura M; Silver, Michael R; Hanfelt, John et al. (2018) Pilot Single-Blind Trial of AbobotulinumtoxinA in Oromandibular Dystonia. Neurotherapeutics 15:452-458
Morris, Aimee E; Norris, Scott A; Perlmutter, Joel S et al. (2018) Quantitative, clinically relevant acoustic measurements of focal embouchure dystonia. Mov Disord 33:449-458
Sedov, Alexey; Popov, Valentin; Shabalov, Vladimir et al. (2017) Physiology of midbrain head movement neurons in cervical dystonia. Mov Disord 32:904-912
Shaikh, Aasef G; Factor, Stewart A; Juncos, Jorge (2017) Saccades in progressive supranuclear palsy - maladapted, irregular, curved, and slow. Mov Disord Clin Pract 4:671-681

Showing the most recent 10 out of 110 publications