Objective: To evaluate the frequencies and clinical features of non-motor symptoms in several different hyperkinetic movement disorders and compare them with the healthy age- and sex-matched control group.

Background: Hyperkinetic movement disorders are neurological syndromes characterized by involuntary movements occurring during volitional and automatic actions, in the absence of paresis and spasticity. In the last few years, the presence of non-motor symptoms has gained notice in hyperkinetic movement disorders and  a few studies investigating non-motor symptoms in essential tremor and dystonia were reported. However, more research needs to be done in this area in order to fully understand the many faces of these hyperkinetic disorders.

Method: Forty-six patients with focal dystonia (25 cervical dystonia (CD), 21 belpharospasm), 20 with essential tremor (ET), 11 with Huntington’s disease (HD) and 25 healthy controls were recruited for this study. All cases underwent complete neurological examination. The presence of orthostatic hypotension was evaluated in each subject. Mini Mental ExaminationTest, Pittsburgh Sleep Quality Index, Beck Depression Scale, Hamilton Anxiety Scale, Fatigue Severity Scale, Visual Analog Scale for pain and Non-motor symptom scale were performed in all subjects.

Results: Cognitive impairment was prominent in HD. Concentration and memory problems were also detected in both CD and ET. In ET, there was a correlation between the age at onset and the severity of cognitive dysfunction. Mood impairment, anxiety, and depression were prominent in CD, ET and HD. Patients with blepharospasm suffered from anxiety disorders. Fatigue and pain were prominent in CD and HD, while gastrointestinal and sexual dysfunction were prominent in focal dystonias. Sleep quality was affected in at least 40% of the cases, except patients with blepharospasm.

Conclusion: In hyperkinetic movement disorders, nonmotor symptoms can be  as disabling as motor symptoms. It is important to increase awareness of these symptoms, in order to provide solutions to the problem and to increase the quality of life of  these patients.

References: Chaudhuri KR, Healy DG, Schapira AH, Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol. 2006;5:235–245. Stamelou M, Edwards MJ, Hallet M, Bhatia KP. The non-motor syndrome of primary dystonia: clinical and pathophysiological implications,. Brain 2012;135:1668-1681. Han v, Skorvanek M, Gdovinova Z. Prevalance of non-motor symptoms in cervical dystonia. Act. Nerv Super Rediviva 2016;58(2):47-49. Louis ED. Non-motor symptoms in essential tremor: A review of the current data and state of the field. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S115-8.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-hyperkinetic-movement-disorders/