Objective: This study aimed to examine whether botulinum neurotoxin (BT) treatment affects nonmotor symptoms of dystonia, particularly depression (D), anxiety (A) and sleep disturbances (SD) in patients with craniocervical dystonias (CCD).

Background: It is known that depression (D), anxiety (A), and sleep disturbances (SD) tend to be common in patients with focal forms of dystonia, being reported to affect the quality of life.

Method: The study comprised 28 patients with craniocervical dystonia, including 22 patients with cervical dystonia (CD) and 6 patients with blepharospasm (BS). Seventeeen (77.3%) of patients with CD were women, and 5 (22.7%) were men; mean age was 39.0±12.6 years. Five (83.3%) patients with BS were women and 1 (16.7%) was a man with a mean age of 61,6±5,4 years. All patients were screened using the Unified Dystonia Rating Scale and CD patients were also assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), Modified Tsui Scale for Cervical Dystonia (TSUI) and craniocervical dystonia questionnaire (CDQ-24). The evaluation of D and A was performed using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The presence of SD was evaluated by Pittsburgh Sleep Quality Index (PSQI). Patients also completed a questionnaire developed to learn about continuance of illness and BT treatment regularity.

Results: Four patients (18.2%) had received a primary diagnosis of CD and 1 (16,7%) patient was primarily diagnosed with BS, and 18 (81.8%) patients with CD and 5 (83,3%) patients with BS had previously received BT injections. Nineteen (82,7%) of BTA receivers were regularly injected (more than 3 times a year). Twelve patients (54.6%) were diagnosed with both D and A. Nine (40,1%) of CD patients complained of SD. A correlation was found between BDI and TWSTRS scores (r=0,58; 16.0±10.4; 26.7±13.1), BDI scores and TSUI scores (r=0.62; 16.0±10.4; 10.7±3.8) and also CDQ-24 scores and TSUI scores (0,61; 72.4±26.0; 10.7±3.8). Three (50.0%) patients with BS had В and A and 2(33.3%) of those had SD.

Conclusion: D, A, and SD are common in patients with CD. These conditions should be considered among primarily diagnosed patients and regular BTA receivers. More studies with bogger samples are needed to be conducted in order to acquire information about the influence of regular BTA injections on D, A, and SD among patients with CCD.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/depression-anxiety-and-sleep-disturbances-in-patients-with-craniocervical-dystonias/