Objective: To evaluate the features of the quality of life (QOL) and related disorders in patients with focal dystonia (FD).

Background: Studying neuropsychological disorders is important for assessing their impact on course of FD, patients QOL, understanding of common etiological and pathogenic mechanisms, choosing most effective approaches to treatment.

Methods: 38 patients (25-66 years) with focal dystonia (blepharospasm n = 22, spasmodic torticollis n = 16) were observed during two years. We used questionnaires for assessment fatigue, insomnia, QOL, neuropsychological methods for determining level of anxiety and depression. All patients received Botulinum toxin (BT) 3-4 times a year and underwent examinations before therapy with BT and after one month (achieving maximum effect).

Results: Half of patients with blepharospasm diagnosed chronic tension headache (TH). Muscle spasms, muscle hypertonicity followed by significantly pronounced muscular-tonic syndrome, TH in majority of patients with spastic torticollis. Nowadays it is believed that pain afferentation supports and enhances neurotransmitter imbalances, contributing development of extrapyramidal disorders. In 2/3 of the cases evaluated polialgic syndrome. Pain, significantly affects emotional background of patients (79,3%- high level of anxiety, depression), sleep quality (65.8%), followed by, hampered daily activities, affects QOL, which was reduced in all patients. According to QOL questionnaire, dissatisfaction from current life situation was noted in 93.6% of patients, decrease of self-concept -61,7%, anxiety about the future – at 57.7%, decrease in social contact – at 59.7%. Severity of comorbidities was significantly higher before BT therapy and decreased against the reducing clinical manifestations of dystonic disorders month after BT therapy. It was found that psychosomatic disorders has negative influence on the effectiveness duration of BT. Dynamic observation showed that prescription of antidepressants to patients with high levels of anxiety, depression not only reduces emotional disorders and associated insomnia, improves QOL, but also contributes to lengthening positive clinical effect of BT.

Conclusions: Algic and comorbid psychosomatic disorders are frequently observed in FD, adversely affects the course of the underlying disease, QOL, reduces duration of BT effect, requires consideration in the planning of rehabilitation measures.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/features-of-the-quality-of-life-and-related-disorders-in-patients-with-focal-dystonia/