Objective: To assess the prevalence of mood disorder and measure health-related quality of life (Hr-QoL) in relation to, pain, disability and disease severity in cervical dystonia (CD) patients receiving botulinium toxin with good effect.

Background: CD presents as a motor disorder; but coexisting mood disorders are frequent and can impact on HrQoL. These mood disorders are considered primary, often precede the onset of CD and do not improve with botulinium toxin therapy.

Method: We prospectively collected data using questionnaires; Toronto Western Spasmodic Torticollis Rating Scale (REVISED) (TWSTRS-2) for pain, severity and disability; cervical dystonia impact profile -58 (CDIP-58) and Euro-QoL visual analogue scale (VAS) for HrQoL and Beck’s Anxiety Inventory (BAI), Beck’s Depression Inventory (BDI-II) & Hospital Anxiety & Depression Scale (HADS) for mood disorder assessment.

Results: In 160 patients, (63% women) with mean age 62 years (SD: 12.67), using the BAI and BDI-II, 50% reported anxiety and/or depression (Table 1). There were significant correlations between mood disorder and quality of life using CDIP-58 {(Anxiety: R2=0.39; p<0.0001) and (Depression: R2=0.33; p<0.0001)}. There were weaker correlations between disease severity (physician administered), disability and quality of life; R2=0.09; p<0.0002 and R2=0.18; p<0.0001 respectively (Table 2).

Conclusion: There were significant correlations between reported mood disorder and HrQoL in CD but weaker associations with severity and disability scales. This shows that patient-reported measures, in particular, the CDIP-58, are a source of significant disability reporting which is not determinable by standard recommended measures of CD severity, administered by the neurologist. As such it is important to trust the patient.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/trust-the-patients-report-not-the-doctors-non-motor-symptoms-and-quality-of-life-in-cervical-dystonia/