Cognitive Profiling in Focal Dystonia: Selective Executive, Working Memory and Attention Impairments Revealed by Domain-Specific Testing - A Case-Control Study

Background: Previous studies examining the level and pattern of cognitive impairment in focal dystonias have yielded inconsistent results. Therefore, further prospective research comparing patients with precisely matched healthy controls –for age, sex, place of residence, educational level, and depression and anxiety scores – may provide more robust and reliable findings. Objective: In line with this approach, the aim of the present study was to provide a detailed cognitive profile of patients with cervical dystonia (CD) and blepharospasm (BS). Methods: This observational, cross-sectional, matched case-control study included 22 patients with CD or BS receiving regular botulinum toxin injections at three-month intervals, and 22 matched healthy controls. Cognitive evaluation was performed using the Montreal Cognitive Assessment, followed by a detailed online cognitive evaluation with the validated Hungarian CogProfile tool, administered before the scheduled injection. Results: Patients with CD and BS exhibited impairments in executive function, working memory, and sustained attention, independent of depression and anxiety scores, while language and perceptual abilities were preserved. Conclusions: These findings support the presence of cognitive features among the non-motor symptoms of focal dystonia, underscoring the importance of incorporating cognitive screening into routine clinical assessments.