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PhD defence Elze Timmers

Last November 2, PhD student Elze Timmers defended her thesis entitled “Non-motor symptoms in dystonia” in the academy building of the University of Groningen. Her PhD research took place at the Expertise Center for Rare Movement Disorders at the Department of Neurology of the University Medical Center Groningen. In recent years, Elze has conducted her research under the supervision of Marina de Koning-Tijssen, Tom de Koning and Klary Niezen-Koning.

Dystonia is a movement disorder in which patients suffer from involuntary repetitive movements and/or abnormal postures. In addition to the problems with movement, patients also have non-motor symptoms, such as psychological complaints, sleep problems and fatigue. These non-motor symptoms often remain underexposed, but they do have a major impact on quality of life. In her thesis, Elze has mapped the non-motor symptoms in three forms of dystonia: dopa-responsive dystonia (DRD), myoclonus dystonia (M-D) and cervical dystonia. In all of these forms of dystonia, non-motor symptoms were more common than in people without dystonia (57-74% vs. 29%). In addition, it was apparent that certain psychiatric symptoms were more often present in specific forms of dystonia. M-D patients showed relatively more often symptoms consistent with a compulsive disorder, while DRD patients often showed symptoms of an anxiety disorder. Another important finding is that the non-motor symptoms had a significant impact on the patients' quality of life, even more than the movement disorder itself. These results show the need for adequate and personalized treatment of the non-motor symptoms.

In the second part of her thesis, Elze focused on the role of the messenger substance serotonin in the symptoms of dystonia. At various levels, both in the blood and in the brain, she found small changes in the metabolism of serotonin, and in addition, there was sometimes a connection with the non-motor symptoms. This shows that serotonin may play a role in the non-motor symptoms. Further research may eventually lead to better treatment options for patients.

Obtaining her doctorate was of course then celebrated with family, friends and colleagues.