Indeed many clinical data point to dopaminergic dysregulation as a key player in dystonia (e.g. DRD, OFF). I see DA–ACh imbalance as fundamental; prior work suggests cholinergic tone may even set the polarity of D2 modulation.

We built this model of dystonia by increasing cholinergic tone in the putamen. Oxotremorine infusion induced dystonic postures ressembling human dystonia, striatal hypermetabolism, pallidal firing changes and low-frequency oscillations, highlighting striatal cholinergic dysregulation as a key driver