Objective: The aim of our study was to assess the concordance of different evaluation approaches of non-motor symptoms (NMS) in patients with cervical dystonia (CD).

Background: Despite the purely motor-related definition of CD, evidence is growing that NMS are frequently present in CD and that they are possibly intrinsic symptoms of dystonia. Specific rating scales for evaluating NMS in CD, like the Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest), provide a simple self-reported overview of NMS prevalence burden, while symptom-specific scales, like Beck’s Depression Inventory (BDI), assess only a single NMS, but in more detail, including symptom severity. Due to the limited research done on this topic thus far, it is not clear what the concordance is between these evaluation approaches.

Method: We enrolled 93 consecutive patients with idiopathic CD from four Slovak specialized dystonia outpatient clinics, which serve as treatment centers for CD. The presence of NMS was assessed by DNMSQuest and simultaneously by the symptom-specific scales (BDI-II, Beck’s Anxiety Inventory, Starkstein’s Apathy Scale, Multidimensional Fatigue Inventory, Pittsburgh Sleep Quality Index) where recommended cut-offs were applied.

Results: Comparison of a scale-based assessment of NMS with their evaluation by a single question according to the DNMSQuest shows the highest concordance for disrupted sleep (81.6% of congruent results in the PSQI and the DNMSQuest). Considerable concordance was also observed when evaluating depression (70.9%), anxiety (70.7%), general and physical fatigue (73.9% and 72.0%, respectively) and apathy (68.8%).

Conclusion: Despite the relatively high concordance of both approaches, there were still 18-28% of patients whose self-estimated presence/absence of a particular NMS in the DNMSQuest was incongruent with the result of the scale specific to that NMS. Simultaneous screening for NMS by both approaches may increase the detection rate, however, at the cost of increased clinical effort. This elicits the need for a useful questionnaire capable of screening for CD-related NMS while simultaneously evaluating their severity.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/concordance-of-different-evaluation-approaches-of-non-motor-symptoms-in-patients-with-cervical-dystonia/