Drug Therapy, Combination / Depression · Journal article

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

Annals of Medicine · August 20, 2026

Preliminary Why this matters to you Expert discussion

Early or partial results. Treat as a signal, not a conclusion.

AI Summary

This non-interventional pilot study reports that pridinol mesylate added to botulinum toxin treatment produced significant improvements in motor symptoms (TWSTRS part I) and depression scores (BDI-II) over 12 weeks in 20 cervical dystonia patients, with partial improvement in pain. The lack of a control group, small sample size, and uncontrolled design mean this finding is preliminary and requires confirmation in a randomized controlled trial before clinical adoption.

What was studied

Non-interventional pilot study. Cervical dystonia patients on botulinum toxin treatment enrolled at initial visit.. Intervention: Pridinol mesylate added to botulinum toxin treatment. n = 20.

Key findings

TWSTRS part I motor score significantly improved from V1 to V3 with pridinol addition to BoNT BDI-II depression score significantly improved from V1 to V3 TWSTRS part III pain showed effect between V1 and V2, remained unchanged until V3

Safety

No information on adverse events, tolerability, or adherence

Who this may help

Clinicians should not adopt pridinol as an adjunct to botulinum toxin for cervical dystonia based on this pilot; larger, controlled trials with pre-specified endpoints are needed to establish efficacy and safety before clinical practice change.

Plain-language summary

Non-interventional pilot study in 20 patients without a control arm, reporting motor and pain improvements with pridinol added to botulinum toxin, but lacking comparative evidence and power to support clinical decision-making.

Study design

As stated by the source record.

Methods20 cervical dystonia patients received pridinol mesylate added to standard botulinum toxin treatment at initial visit (V1), with follow-up assessments at 4 weeks (V2) and 12 weeks (V3). Motor and non-motor symptoms were assessed using TWSTRS, DNMSQuest, BDI-II, and EQ-5D-5L. Analysis included correlation examination between outcome scales.

DesignNon-interventional pilot study

PopulationCervical dystonia patients on botulinum toxin treatment enrolled at initial visit.

Sample size20

InterventionPridinol mesylate added to botulinum toxin treatment

Reported figures

Quoted from the source exactly as published.

Sample size20

Follow-up duration12 weeks

TWSTRS part I motor scoresignificantly improved V1 to V3

BDI-IIsignificantly improved V1 to V3

TWSTRS part III painsome effect V1 to V2, unchanged until V3

Clinical bottom line

Caveats

No control or comparator group; cannot determine if improvements exceed natural history or placebo effect
No specific p-values or effect sizes reported for primary endpoints
No confidence intervals reported for any outcome measures
No information on adverse events, tolerability, or adherence

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

limited

Non-interventional pilot design without control group or randomization.

Directness

moderate

Examines motor and non-motor outcomes in cervical dystonia patients using validated scales.

Consistency

insufficient

Single-arm study; no comparator group or reference to consistency with other data.

Risk of bias

limited

No blinding, no control, uncontrolled add-on design limits causal inference.

Sample adequacy

insufficient

20 patients in pilot study; no sample size calculation or power analysis reported.

Source abstract

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.

Follow from this

Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.

Alexander BaumannDrug Therapy, CombinationCarl Alexander GlessKirsten E ZeunerDana-Kristin BrinkerDepressionJos Steffen BecktepeInken Toedt