Al Hussona M, Chindukwe I, Dover J, Beck R, Reilly RB, O’Riordan S, Hutchinson M
Proceedings of 22nd International Congress of Parkinson’s Disease and Movement Disorders, Hong Kong, 2018. (Also published in Proceedings of 4th European Academy of Neurology Congress, Lisbon, 2018, and in Proceedings of Annual Meeting of the Association of British Neurologists, Birmingham).
ABSTRACT:
BACKGROUND:
Non-motor symptoms, particularly anxiety and depression are prominent in cervical dystonia and can affect quality of life, despite effective therapy of motor symptoms with botulinum toxin. Our aim was to assess the prevalence and severity of mood disorder in our cervical dystonia population attending the botulinum toxin clinic and to assess their effect on quality of life.
PATIENTS & METHODS:
We prospectively collected data on measures of anxiety and
depression in patients with cervical dystonia attending a University Hospital specialist clinic. Health related quality of life (HrQoL) was assessed using the Cervical Dystonia Impact Profile–58 (CDIP-58); mood disorder was assessed using the Beck Anxiety Index (BAI-II), Beck Depression Index (BDI); Dystonia severity was assessed using the TWSTRS-2 severity scale and the TWSTRS-2 Pain Scale
RESULTS:
70 patients (50 women) with cervical dystonia were surveyed; 28/70 (40%) reported symptoms of anxiety using the BAI (20% had scores indicating moderate to severe anxiety). In 66 patients who completed the BDI-II, 30 (45%) reported symptoms of depression; 18/66 (27%) had BDI-II scores indicating moderate to severe depression. 40/70 (57%) patients reported depression and/or anxiety. There was a weakly significant correlation between anxiety, measured by the BAI and the TWSTRS pain scale (R2 = 0.163; p = 0.0006) but no correlation with the TWSTRS–2 severity scale (R2 = 0.024; p = 0.2). Similarly depression measured by the BDI–II correlated weakly with the TWSTRS pain scale (R2 = 0.151; p = 0.001) but no correlation with the TWSTRS–2 severity scale (R2 = 0.009; p = 0.44). In a subset of 38 patients who had also completed a health-related quality of life assessment using the CDIP58, there were significant correlations between self-reported symptoms of anxiety and disease impact (CDIP-58)(R2 = 0.44; p < 0.0001) and also between self reported symptoms of depression and disease impact (R2 = 0.33; p = 0.0002).
CONCLUSION:
A significant proportion (57%) of patients with cervical dystonia have concurrent anxiety and/or depression. The lack of correlation with disease severity and low correlation with pain indicates that non-motor symptoms may have pathogenetic mechanisms unrelated to the motor disorder.
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Copyright: © 2018