Objective: To determine the feasibility of utilising a guided, internet-based, self-help cognitive behavioural therapy (CBT) programme for the management of psychiatric symptoms in patients with adult-onset primary focal cervical dystonia (CD).

Background: A consistent psychiatric phenotype, has been demonstrated in CD and this has been shown to have a significant impact on quality of life.  Despite this, there is currently no standardised model for the management of these symptoms. CBT has shown promising results, but factors including cost, limited resources, and waiting times limits access to face-to-face psychological therapy. Online, guided self-help CBT programmes may offer a solution to these obstacles and provide an effective management option for psychiatric symptoms in CD.

Method: Twenty participants with CD identified to have mild/moderate anxiety or depression based on survey response data were randomised into either the control or treatment group. Non-motor and motor symptoms were assessed at baseline, three- and six-months. Participants in the treatment group were instructed to complete an online CBT programme over eight weeks and asked additional questions about the programme. Participants were classified as either “Low engagement”, “Medium engagement” or “High engagement” based on the amount of the programme completed within the eight weeks. Non-motor and motor scores were compared between groups at each timepoint to determine any symptoms effects. Participants in the “Low engagement” group were excluded from this analysis.

Results: The majority of participants in the treatment arm (n=10) showed high engagement with the online CBT programme, reporting that they found the programme useful, and they would continue to use it. Although there were no significant differences found, there was a trend towards improved non-motor scores in the treatment group at 3 months post enrolment.

Conclusion: Overall, the use of online CBT in individuals with CD is feasible, with the majority of individuals engaging with the programme and finding it useful. Although there may be a small benefit in psychiatric and other non-motor symptoms, increased sample sizes are needed to determine if the online CBT course provides a significant benefit in the management of these symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-feasibility-of-using-an-internet-based-cognitive-behavioural-therapy-programme-as-an-intervention-for-people-diagnosed-with-adult-onset-focal-isolated-idiopathic-cervical-dystonia/