Cervical dystonia and quality of life

Abstract

Cervical dystonia is focal dystonia characterized by involuntary movement of the neck muscle, which leads to abnormal head posture. It can be accompanied with pain and tremor. In this study, we evaluated the presence of depression and anxiety in patients with cervical dystonia and the influence of dystonia symptoms on the quality of life. Psychiatric symptoms were evaluated by use of the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to evaluate the cervical dystonia symptoms. Quality of life was assessed by the craniocervical dystonia questionnaire (CDQ-24) and short form 36 health survey (SF-36). Nineteen patients were analyzed. Most of the patients had mild cervical dystonia (mean TWSTRS 23.89). Depression was present in 42.1 % and anxiety in 57.9 % of the patients. Disability due to cervical dystonia correlated with the occurrence of depression (ρ = 0.534) and anxiety (r = 0.652). Disability was found to significantly influence the stigma, emotional state, pain, daily activity, social life, physical function, and physical and mental disability. Pain influenced some aspects of body pain, physical function, and physical and mental disability. Being associated with disability and pain, cervical dystonia decreases the quality of life in many aspects. Disability also influenced depression and anxiety, which were present in half of study patients. In addition to follow up for cervical dystonia symptoms, patients with cervical dystonia should also be assessed for psychiatric symptoms on routine clinical check-ups. In addition to botulinum toxin, psychopharmaceuticals should be considered as a treatment option in these patients.

Clinical evaluation of non-motor symptoms in jaw closing dystonia

“…The present patients showed reduced QOL, based on their OHIP-49 and SF-36 scores. Zurowsky et al [27] as well as others have confirmed that psychiatric illnesses have a major impact on QOL of patients with dystonia [34][35][36]. In our study, the dystonia patients consistently demonstrated lower QOL as compared to the healthy controls.…”

Long‐term GPi‐DBS improves motor features in myoclonus‐dystonia and enhances social adjustment

“…Postoperative health‐related QoL assessed by the SF‐36 scale was good and similar to that of the data from the French general population of a similar age . Different results were reported in patients with cervical dystonia treated with botulinum toxin injections, with depression the main predictor of worse QoL, and in patients with isolated generalized dystonia treated by GPi‐DBS with dissociation between motor improvement and impact on QoL …”

Caregiver burden and health-related quality of life in idiopathic dystonia patients under botulinum toxin treatment: a cross-sectional study

“…Furthermore, the German version of Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive functioning (Nasreddine et al 2005). All patients suffering from a cervical dystonia were also assessed with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) (Consky et al 1990) and the craniocervical dystonia questionnaire (CDQ-24) for disease-specific HR-QoL (Mueller et al 2016). All participants (patients and their caregivers) were asked to complete the WHO Short Form 36 (SF-36) Health Survey for assessment of their HR-QoL (Ware and Donald-Sherbourne 1992), the Beck Depression Inventory (BDI) (Beck et al 1961), the Toronto-Alexithymia Scale (TAS-26) (Bagby et al 1994), and the STAI (STAI-S state anxiety and STAI-T trait anxiety) (Spielberger et al 1983).…”