Effect of botulinum toxin treatment on quality of life in patients with isolated lingual dystonia and oromandibular dystonia affecting the tongue

Abstract

The purpose of this study was to investigate the impact of botulinum toxin (BoNT) treatment on the quality of life (QoL) for patients with prominent lingual dystonia (LD) using a disease-specific questionnaire, the oromandibular dystonia questionnaire-25 (OMDQ-25). This is a prospective, observational study of a cohort of 30 patients treated with BoNT injections for LD, with or without concurrent jaw dystonia. Primary efficacy outcome was the absolute difference between total OMDQ-25 baseline score and total OMDQ-25 scores 4 and 8 weeks after the treatment. Safety outcome was the occurrence of adverse effects. The mean total OMDQ-25 baseline score was 46.8 ± 17.8. After BoNT treatment, there was a significant reduction in the mean total OMDQ-25 score at 4 weeks (38.2 ± 17.6; p = 0.004), as well as at 8 weeks (39.6 ± 18.1; p = 0.008). At the multiple regression analysis, a jaw deviation pattern (JDD) and high questionnaire baseline total score were detected as predictors of a better outcome, whilst associated jaw tremor was a predictor of poor outcome. In patients with JDD, jaw-opening muscles were more frequently injected and genioglossus less frequently than in patients without JDD. No major adverse events were detected. A consistent and measurable improvement in QoL, with good safety and tolerability, can be achieved in patients with prominent LD by injecting BoNT into genioglossus and/or other muscles of the oromandibular region.

Oromandibular dystonia, mental distress and oro‐facial dysfunction—A follow‐up 8‐10 years after start of treatment with botulinum toxin

“…Little systematic information has been published on the course of OMD over time and the treatment effect, but in general, it seems that BoNT treatment is well tolerated and improves function and quality of life . However, to facilitate research and clinical practice, precise tools to rate improvement or deterioration are important to assess disease state and outcome after treatment .…”

Perspectives on the Psychosocial Management of Oromandibular Dystonia

“…Natasi et al used the OMDQ-25 to investigate the impact of BoNT-A injections on QoL for individuals with predominantly lingual dystonia. 49 Overall, this study reported that BoNT-A injections can result in a consistent and measureable improvement in QoL for individuals with predominantly lingual dystonia. Merz and colleagues also reported improvements across all subscales of the OMDQ-25 following BoNT-A injections, with the "cosmetic" subscale demonstrating the greatest improvement following injections with BoNT-A.…”

“…The majority of these published studies have evaluated health-related QoL before and after botulinum toxin injections to determine if this medical intervention is effective for improving QoL. 1,48,49 Most of these studies have used the Glasgow Benefit Inventory (GBI) to measure the change in a patient's health produced by an intervention. The GBI is an 18-item questionnaire, divided into three domains (general subscore, social support subscore, physical health subscore).…”

“…Natasi and colleagues published one of the first studies to examine health-related QoL using an OMD-specific health-related QoL instrument called the Oromandibular Dystonia Questionnaire (OMDQ-25). 5,49 The OMDQ-25 is a 25-item questionnaire divided into five subscales that evaluates psychosocial, cosmetic, speech, eating, as well as a "general" score that contributes to an overall health-related QoL score. Each item is rated on a 5-point scale with a range of descriptors relating to degree of impairment: never, seldom, sometimes, often, and always.…”

Pilot Single-Blind Trial of AbobotulinumtoxinA in Oromandibular Dystonia

“…Several studies have shown that QoL improves with toxin treatment of OMD [13,14]. The OMDQ-25 is a validated instrument that has been shown by us and others to demonstrate response [12,34].…”