Non-motor conditions in patients with cervical dystonia

Close metadata

OBJECTIVE

To study non-motor conditions in people with diabetes in comparison with patients with cervicalgia.

MATERIAL AND METHODS

The study included 170 people. The main group consisted of 120 respondents with cervical dystonia (CD) aged 27 to 82 years. The diagnosis of CD was based on the Clinical guidelines for the diagnosis and treatment of dystonia adopted by the European Federation of Neurological Societies, the Society for Movement Disorders and the All-Russian Society of Neurologists. The control group included 50 patients, aged 25 to 82 years, with pain in the cervical spine due to muscle-tonic and myofascial syndromes. A Visual Analogue scale, the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Pittsburgh Sleep Quality Index (PSQI) were administered to study the asthenic syndrome in all patients.

RESULTS AND CONCLUSION

Pain, anxiety, depression, asthenic syndrome, insomnia are statistically significant non-motor conditions in patients with CD compared with patients with cervicalgia. CD significantly affects the physical and psychological aspects, worsening the quality of life of these patients. The following gender differences are identified: in women with CD, non-motor disorders (anxiety, depression, general and physical asthenia, insomnia) are significantly more pronounced and the quality of life is significantly reduced compared to men with CD. For the successful treatment of CD, a multimodal approach is needed that provides the treatment of not only motor, but also non-motor disorders. Early detection and treatment of comorbid conditions is an important step in the treatment of CD.

Keywords:

cervical dystonia

non-motor symptoms

comorbidity

quality of life

Authors:

Druzhinina O.A.

City Polyclinic No. 1

Zhukova N.G.

Siberian State Medical University

Shperling L.P.

Regional Center for Extrapyramidal Diseases with Botulinum Therapy Room

Received:

28.06.2020

Accepted:

15.07.2020

List of references:

Fleischhacker WW, Cetkovich-Bakmas M, De Hert M, Hennekens CH, Lambert M, Leucht S, Maj M, McIntyre RS, Naber D, Newcomer JW, Olfson M, Ösby U, Sartorius N, Lieberman JA. Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. Journal of Clinical Psychiatry. 2008;69(4):514-519. https://doi.org/10.4088/jcp.v69n0401
Payne RA, Abel GA, Guthrie B, Mercer SW. The effect of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned admissions to hospital: a retrospective cohort study. Canadian Medical Association Journal. 2013;185(5):221-228. https://doi.org/10.1503/cmaj.121349
Garin N, Koyanagi A, Chatterji S, Tyrovolas S, Olaya B, Leonardi M, Lara E, Koskinen S, Tobiasz-Adamczyk B, Ayuso-Mateos JL, Haro JM. Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi Country Study. Journals of Gerontology: Medical Sciences. 2015;1:1-10. https://doi.org/10.1093/gerona/glv128
Rijken M, van Kerkhof M, Dekker J, Schellevis FG. Comorbidity of chronic diseases. Quality of Life Research. 2005;14(1):45-55. https://doi.org/10.1007/s11136-004-0616-2
De Hert M, Cohen D, Bobes J, Cetkovich-Bakmas E, Leucht S, Ndetei DM, Newcomer JW, Uwakwe R, Asai I, Möller H-J, Gautam S, Detraux J, Correll CU. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry. 2011;10:138-151. https://doi.org/10.1002/j.2051-5545.2011.tb00036.x
Jakovljević M, Crnčević Ž. Comorbidity as an epistemological challenge to modern psychiatry. Dialogues in Philosophy, Mental and Neuro Sciences. 2012;5(1):1-13.
Zalyalova ZA, Abdulgalimova DM. Bolevoj sindrom do i posle primeneniya disporta u pacientov so spasticheskoj krivosheej. Zhurnal Nevrologii i Psihiatrii im. S.S. Korsakova. 2010;110(11-12):62-65. (In Russ.).
Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013;28:863-873. https://doi.org/10.1002/mds.25475
Defazio G, Jankovic J, Giel JL, Papapetropoulos S. Descriptive epidemiology of cervical dystonia. Tremor Other Hyperkinet Mov. 2013;4:3. https://doi.org/10.7916/D80C4TGJ
Nutt JG, Muenter MD, Melton LJ 3rd, Aronson A, Kurland LT. Epidemiology of dystonia in Rochester, Minnesota. Adv Neurol. 1988;50:361-365.
Fukuda H, Kusumi M, Nakashima K. Epidemiology of primary focal dystonias in the western area of Tottori prefecture in Japan Comparison with prevalence evaluated in 1993. Mov Disord. 2006;21:9:1503-1506. https://doi.org/10.1002/mds.20986
Singer C, Velickovic M. Cervical dystonia. Etiology and pathophysiology. Neurologic Clinics. 2008;1:26:9-22. https://doi.org/10.1016/S0733-8619(08)80002-3
Zoons E, Booij J, Nederveen AJ, Dijk JM, Tijssen MA. Structural, functional and molecular imaging of the brain in primary focal dystonia — a review. Neuroimage. 2011;56:3:1011-1020. https://doi.org/10.1016/j.neuroimage.2011.02.045
Albanese A, Sorbo FD. Dystonia and Tremor: The Clinical Syndromes with Isolated Tremor. Tremor Other Hyperkinet Movements. 2016;6:319. https://doi.org/10.7916/D8X34XBM
Reichel G, Stenner A, Jahn A. Zur Phänomenologie der zervikalen Dystonien. Fortschr Neurol Psychiatr. 2009;77(5):272-277. https://doi.org/10.1055/s-0028-1109416
Orlova OR. Fokal’ny’e distonii: sovremenny’e podxody’ k diagnostike i vozmozhnosti botulinoterapii. Nervny’e Bolezni. 2016;4:3-13. (In Russ.).
Bezerra ME, Rocha-Filho PA. Headache Attributed to Craniocervical Dystonia — A Little Known Headache. Headache. 2017;57(2):336-343. https://doi.org/10.1111/head.12996
Eichenseer SR, Stebbins GT, Comella CL. Beyond a motor disoder: a prospective evaluation of sleep quality in cervical dystonia. Park Relat Disord. 2014;20:405-408. https://doi.org/10.1016/j.parkreldis.2014.01.004
Suvorova VA, Antipenko EA. Terapiya astenonevroticheskogo sindroma u pacientov s fokal’ny’mi my’shechny’mi distoniyami. Zhurnal Nevrologii i Psixiatrii. 2018;118(3):56-58. (In Russ.). https://doi.org/10.17116/jnevro20181183156-58
Fabbrini G, Berardelli I, Moretti G, Pasquini M, Bloise M, Colosimo C, Biondi M, Berardelli A. Psychiatric disorders in adult-onset focal dystonia: a case-control study. Mov Disord. 2010;25:459-465. https://doi.org/10.1002/mds.22983
Klinicheskie rekomendacii po diagnostike i lecheniyu distonii: klinicheskie rekomendacii [Elektronnyj resurs]. Glavnyj redaktor Gusev E.I. Vserossijskoe obshchestvo nevrologov. Prezidium. M. 2014. (In Russ.).
Pekmezovic T, Svetel M, Ivanovic N, Dragasevic N, Petrovic I, Tepavcevic DK, Kostic VS. Quality of life in patients with focal dystonia. Clin Neurol Neurosurg. 2009;111(2):161-164. https://doi.org/10.1016/j.clineuro.2008.09.023
Tepavcevic DK, Svetel M, Pekmezovic T, Petrovic I, Kostic VS. Craniocervical Dystonia Questionnaire (CDQ-24): validation and cross-cultural adaptation in Serbian patients. Coll Antropol. 2009;33:1185-1189. https://doi.org/10.1136/jnnp.2003.013441
Tomic S, Petkovic I, Pucic T, Resan B, Juric S, Rotim T. Cervical dystonia and quality of life. Acta Neurol Belg. 2016;116(4):589-592. https://doi.org/10.1007/s13760-016-0634-1
Kongsaengdao S, Maneeton B, Maneeton N. Quality of life in cervical dystonia after treatment with botulinum toxin A: a 24-week prospective study. Neuropsychiatr Dis Treat. 2017;13:127-132. https://doi.org/10.2147/NDT.S116325
Van Den Dool J, Tijssen MA, Koelman JH, Engelbert RH, Visser B. Determinants of cervical dystonia. Parkinsonism Relat Disord. 2016;32:48-53. https://doi.org/10.1016/j.parkreldis.2016.08.014
Farivar SS, Cunningham WE, Hays RD. Correlated physical and mental health summary scores for the SF-36 and SF-12 Health Survey, V.I. V.I. Health Quality Life Outcomes. 2007;7:5:54. https://doi.org/10.1186/1477-7525-5-54
Charles PD, Adler CH, Stacy M, Comella C, Jankovic J, Manack Adams A, Schwartz M, Brin MF. Cervical dystonia and pain: characteristics and treatment patterns from CD PROBE (Cervical Dystonia Patient Registry for Observastion of Onabotulinumtoxin A Efficacy). J Neurol. 2014;261:1309-1319. https://doi.org/10.1007/s00415-014-7343-6
Smit M, Kuiper A, Han V, Jiawan VC, Douma G, van Harten B, Oen JM, Pouwels ME, Dieks HJ, Bartels AL, Tijssen MA. Psychiatric co-morbidity is highly prevalent in idiopathic cervical dystonia and significantly influences health-related quality of life: Results of a controlled study. Parkinsonism & Related Disorders. 2016;30:7-12. https://doi.org/10.1016/j.parkreldis.2016.06.004
Chernuxa TN, Lixachev SA. Osobennosti psixoe’mocional’nogo statusa pacientov s my’shechnoj distoniej. Nevrologiya i nejroxirurgiya. Vostochnaya Evropa (Minsk). 2016;6(4):506-515. (In Russ.).
Wagle Shukla A, Brown R, Heese K, Jones J, Rodriguez RL, Malaty IM, Okun MS, Kluger BM. High rates of fatigue and sleep disturbances in dystonia. Int J Neurosci. 2016;126(10):928-935. https://doi.org/10.3109/00207454.2015.1085035
Paus S, Gross J, Moll-Müller M, Hentschel F, Spottke A, Wabbels B, Klockgether T, Abele M. Impaired sleep quality and restless legs syndrome in idiopathic focal dystonia: a controlled study. J Neurol. 2011;258:1835-1840. https://doi.org/10.1007/s00415-011-6029-6
Avanzino L, Martino D, Marchese R, Aniello MS, Minafra B, Superbo M, Defazio G, Abbruzzee G. Quality of sleep in primary focal dystonia: a case-control study. Eur J Neurol. 2010;17:576-581. https://doi.org/10.1111/j.1468-1331.2009.02884.x
Eichenseer SR, Stebbins GT, Comella CL. Beyond a motor disoder: a prospective evaluation of sleep quality in cervical dystonia. Park Relat Disord. 2014;20:405-408. https://doi.org/10.1016/j.parkreldis.2014.01.004
Augood SJ, Hollingsworth Z, Albers DS, Yang L, Leung JC, Muller B, Klein C, Breakefield XO, Standaert DG. Dopamine transmission in DYT1 dystonia: a biochemical and autoradiographical study. Neurology. 2002;59(3):445-448. https://doi.org/10.1212/wnl.59.3.445
Hasler G, Northoff G. Discovering imaging endophenotypes for major depression. Molecular Psychiatry. 2011;16(6):604-619. https://doi.org/10.1038/mp.2011.23
Jimenez-Jimenez FJ, Molina JA. Extrapyramidal Symptoms Associated with Selective Serotonin Reuptake Inhibitors. CNS Drugs. 2000;14:367-379. https://doi.org/10.2165/00023210-200014050-00004
Zalyalova ZA, Bogdanov EI. Ostry’e lekarstvenny’e e’kstrapiramidny’e narusheniya. Zhurnal Nevrologii i Psixiatrii im. S. S. Korsakova. 2003;103(4):48-54. (In Russ.).
Zalyalova ZA, Xafizova IF, Xayatova ZG. Patofiziologicheskie osnovy’ reabilitacii pri cervikal’noj distonii. Faramateka. 2017;15:7-15. (In Russ.).
Bhidayasiri R, Bronstein JM. Improvement of cervical dystonia: possible role of transcranial magnetic stimulation simulating sensory tricks effect. Medical Hypotheses. 2005;64(5):941-945.
Zeuner KE, Molloy FM. Abnormal reorganization in focal hand dystoniasensory and motor training programs to retrain cortical function. Neuro Rehabilitation. 2008;23(1):43-53.
Zeuner KE, Hallett M. Sensory training as treatment for focal hand dystonia: a 1-year follow-up. Movement Disorders. 2003;18(9):1044-1047. https://doi.org/10.1002/ana.10174
Tassorelli C, Mancini F, Balloni L, Pacchetti C, Sandrini G, Nappi G, Martignoni E. Botulinum toxin and neuromotor rehabilitation: An integrated appraoch to idiopathic cervical dystonia. Movement Disorders. 2006;21(12):2240-2243. https://doi.org/10.1002/mds.21145

Close metadata