Objective: We aimed to describe several non-motor features in two types of dystonia- writer’s cramp (WC) and cervical dystonia (CD) and compare them.

Background: There has been emerging recognition of non-motor symptoms in various forms of dystonia in recent literature, including sleep, pain, mood disturbances, and quality of life.

Method: In this single-center, cross-sectional study, we enrolled patients with isolated adult-onset focal WC and CD. We assessed their clinical, demographic and treatments details. We also assessed and compared four non-motor features, which included Numeric Pain Rating scale (NPRS), anxiety (Hamilton Anxiety Rating scale), depression (Hamilton Depression Rating Scale), sleep disorders (Pittsburg Sleep Quality Index). Dystonia severity was assessed using Global Dystonia Severity Rating Scale (GDS) and Toronto Westerns Torticollis Rating Scale (TWSTRS).

Results: We enrolled 65 patients with CD (65% males), and 55 patients with WC (75% males). The median age at onset for CD was 55.5 years (interquartile range 36-60) and for WC was 28.7 (21-45) years. The median disease duration for CD was 7.3 (3.5-9) years and for WC was 3.2 (2.6-4.5) years. Patients with CD had significantly higher HAM-D score compared to WC (21 (13-26) versus 16 (14-19); p<0.05) and reported more sleep disturbances on PSQI (12 (9-15) versus 7 (5-11); p<0.05). Patients receiving botulinum treatment had less non-motor burden compared to those not receiving botulinum treatment.

Conclusion: Indian patients with cervical dystonia were observed to harbour significant burden of non-motor symptoms, including higher levels of depression and impaired sleep quality compared to patients with writer’s cramp. Although burden of non-motor features was high in both groups, it seemed to be ameliorated with botulinum treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-burden-of-non-motor-symptoms-in-adult-onset-focal-idiopathic-dystonia-a-comparative-cross-sectional-study/