Prevalence of non‐motor symptoms and their association with quality of life in cervical dystonia

Han, Vladimir; Škorvánek, Matej; Smit, Marije; Koprusakova, Monika Turcanova; Hoekstra, Tialda; Dijk, Jitse P. van; Tijssen, Marina A. J.; Gdovinová, Zuzana; Reijneveld, Sijmen A.

doi:10.1111/ane.13304

Cited by 27 publications

(31 citation statements)

References 37 publications

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“…MS and MS-related pain should of course be treated to improve and stabilize HR-QoL. [31][32][33][34][35] Dystonic tremor is a frequent clinical sign in dystonia 36 and tremor is a source of reduced QoL in other tremor types. 37 The impact of dystonic tremor on HR-QoL in dystonia patients has previously not been sufficiently addressed.…”

Section: Influence Of Ms and Nms On Hr-qol In Dystoniamentioning

confidence: 99%

Quality of life in isolated dystonia: non-motor manifestations matter

Junker

Berman

Hall

et al. 2021

J Neurol Neurosurg Psychiatry

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ObjectiveTo evaluate the relationship between health-related quality of life (HR-QoL) and both physical and psychiatric factors in a large, international, multicentre cohort of patients with isolated dystonia, the Dystonia Coalition.MethodsNatural history data from 603 patients with isolated dystonia (median age 57 years (IQR: 48 to 64 years), 67.0% women) were prospectively acquired and analysed. HR-QoL (RAND 36-Item Health Survey), severity of depressive symptoms, generalised anxiety (Hospital Anxiety and Depression Scale) and social anxiety (Liebowitz Social Anxiety Scale) were assessed. Dystonia severity (Burke-Fahn-Marsden Dystonia Rating Scale) and dystonic tremor were examined. Statistical predictors of HR-QoL were calculated using saturated path analysis.ResultsReduced HR-QoL was strongly associated with the degree of depressive symptoms and generalised and social anxiety (8/8 RAND 36 subscales, p≤0.001). Increased dystonia severity was associated with worse physical functioning, physical and emotional role functioning and social functioning (all p≤0.001). The presence of tremor correlated with worse physical functioning and pain (all p≤0.006). Younger age was associated with reduced emotional well-being and vitality (all p≤0.006). There were no HR-QoL differences between sexes.ConclusionHR-QoL in isolated dystonia is strongly associated with psychiatric and physical features. While current standard of care focus on motor aspects of dystonia, comprehensive care should address both physical and mental aspects of health.

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Section: Influence Of Ms and Nms On Hr-qol In Dystoniamentioning

confidence: 99%

Quality of life in isolated dystonia: non-motor manifestations matter

Junker

Berman

Hall

et al. 2021

J Neurol Neurosurg Psychiatry

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“…In CD, the most frequent NMS are psychiatric symptoms [ 9 , 10 , 11 , 12 , 13 ], as well as sleep habit changes [ 14 , 15 , 16 ] and pain [ 17 , 18 ]. Growing evidence suggests that NMS play a pivotal role as determinants of quality of life and disability in CD patients [ 19 , 20 , 21 ], and a recent cross-sectional study has demonstrated that NMS might also intervene in determining clinical heterogeneity [ 22 ]. Finally, the relationship between motor and NMS is still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, the relationship between motor and NMS is still a matter of debate. Most studies have reported that NMS are independent of CD motor manifestations [ 13 , 20 , 22 ], but it has also been suggested that NMS may represent a secondary manifestation of motor burden [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Botulinum Toxin on Non-Motor Symptoms in Cervical Dystonia

Costanzo

Belvisi

Berardelli

et al. 2021

Toxins

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Patients with cervical dystonia (CD) may display non-motor symptoms, including psychiatric disturbances, pain, and sleep disorders. Intramuscular injection of botulinum toxin type A (BoNT-A) is the most efficacious treatment for motor symptoms in CD, but little is known about its effects on non-motor manifestations. The aim of the present study was to longitudinally assess BoNT-A’s effects on CD non-motor symptoms and to investigate the relationship between BoNT-A-induced motor and non-motor changes. Forty-five patients with CD participated in the study. Patients underwent a clinical assessment that included the administration of standardized clinical scales assessing dystonic symptoms, psychiatric disturbances, pain, sleep disturbances, and disability. Clinical assessment was performed before and one and three months after BoNT-A injection. BoNT-A induced a significant improvement in dystonic symptoms, as well as in psychiatric disturbances, pain, and disability. Conversely, sleep disorders were unaffected by BoNT-A treatment. Motor and non-motor BoNT-A-induced changes showed a similar time course, but motor improvement did not correlate with non-motor changes after BoNT-A. Non-motor symptom changes after BoNT-A treatment are a complex phenomenon and are at least partially independent from motor symptom improvement.

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“…The presence of depression and anxiety were determined using a cut‐off score of ≥14 on the BDI‐II, and ≥10 on the BAI (respectively) 12 . A cut‐off score of ≥8 was used for anxiety in the HADS‐A, which has a specificity of 0.78 and a sensitivity of 0.9; a cut‐off score of ≥8 in HADS‐D has a specificity for depression of 0.79 and a sensitivity of 0.83 13 …”

Section: Methodsmentioning

confidence: 99%

“…The presence of depression and anxiety were determined using a cut-off score of ≥14 on the BDI-II, and ≥10 on the BAI (respectively). 12 A cut-off score of ≥8 was used for anxiety in the HADS-A, which has a specificity of 0.78 and a sensitivity of 0.9; a cut-off score of ≥8 in HADS-D has a specificity for depression of 0.79 and a sensitivity of 0.83. 13 Quality of Life (QoL) QoL was assessed using (1): Utility Values derived the European Quality of Life Questionnaire (EQOL-5D-5L), (2): the EQOL visual analogue score (EQOLVAS), and (3) the total CDIP-58 score.…”

Section: Mood Symptomsmentioning

confidence: 99%

Reliability of DNMSQuest as a Screening Tool for Mood Disorders in Cervical Dystonia

Rafee

Ndukwe

O’Riordan

et al. 2021

Movement Disord Clin Pract

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Background The high prevalence of mood disorders in cervical dystonia, often unaddressed in botulinum toxin clinics, is a major factor in impaired quality of life. There is a clear need for a brief screening method for identifying these disorders; the Dystonia non‐motor symptoms questionnaire (DNMSQuest) has been proposed as such. Objective We aimed to assess the practical utility of the DNMSQuest and compare it with validated rating scales for anxiety, depression and quality of life. Methods In 88 patients with cervical dystonia, we compared results from the DNMSQuest with mood rating scales [Beck Anxiety Inventory (BAI), Beck Depression Index (BDI‐II) and Hospital Anxiety and Depression Scale (HADS)], quality of life measures [European Quality of Life (EQOL) and European Quality of Life Visual Analogue Scale (EQOLVAS)] and with assessments of dystonia severity [Cervical Dystonia Impact Profile‐58 (CDIP58) and Toronto Western Rating Scale for Spasmodic Torticollis (TWSTRS)]. Results Using a cut off score on the DNMSQuest of 5, we noted that DNMSQuest had a sensitivity of 85% for detecting anxiety and depression using the BAI and BDI‐II, and 76% and 78% for anxiety and depression respectively using the HADS. The DNMSQuest correlated strongly with BAI (ρ = 0.715), BDI‐II (ρ = 0.658), HADS‐Anxiety (ρ = 0.616), HADS‐Depression (ρ = 0.706), EQOL (ρ = 0.653) and CDIP‐58 (ρ = 0.665). Conclusion The DNMSQuest is a brief, sensitive and non‐specific instrument for identifying patients that warrant further review for anxiety and depression and can easily be implemented in a neurologist‐run botulinum toxin clinic.

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Prevalence of non‐motor symptoms and their association with quality of life in cervical dystonia

Cited by 27 publications

References 37 publications

Quality of life in isolated dystonia: non-motor manifestations matter

Quality of life in isolated dystonia: non-motor manifestations matter

Effect of Botulinum Toxin on Non-Motor Symptoms in Cervical Dystonia

Reliability of DNMSQuest as a Screening Tool for Mood Disorders in Cervical Dystonia

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