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Cervical dystonia and quality of life

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Abstract

Cervical dystonia is focal dystonia characterized by involuntary movement of the neck muscle, which leads to abnormal head posture. It can be accompanied with pain and tremor. In this study, we evaluated the presence of depression and anxiety in patients with cervical dystonia and the influence of dystonia symptoms on the quality of life. Psychiatric symptoms were evaluated by use of the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to evaluate the cervical dystonia symptoms. Quality of life was assessed by the craniocervical dystonia questionnaire (CDQ-24) and short form 36 health survey (SF-36). Nineteen patients were analyzed. Most of the patients had mild cervical dystonia (mean TWSTRS 23.89). Depression was present in 42.1 % and anxiety in 57.9 % of the patients. Disability due to cervical dystonia correlated with the occurrence of depression (ρ = 0.534) and anxiety (r = 0.652). Disability was found to significantly influence the stigma, emotional state, pain, daily activity, social life, physical function, and physical and mental disability. Pain influenced some aspects of body pain, physical function, and physical and mental disability. Being associated with disability and pain, cervical dystonia decreases the quality of life in many aspects. Disability also influenced depression and anxiety, which were present in half of study patients. In addition to follow up for cervical dystonia symptoms, patients with cervical dystonia should also be assessed for psychiatric symptoms on routine clinical check-ups. In addition to botulinum toxin, psychopharmaceuticals should be considered as a treatment option in these patients.

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REFERENCES

  1. Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS et al (2013) Phenomenology and classification of dystonia: a consensus update. Mov Disord 28:863–873

    Article  PubMed  PubMed Central  Google Scholar 

  2. Van Zandijcke M (1995) Cervical dystonia (spasmodic torticollis). Some aspects of the natural history. Acta Neurol Belg 95(4):210–215

    PubMed  Google Scholar 

  3. Mordin M, Masaqeul C, Abbott C, Copley-Merriman C (2014) Factors affecting the health-related quality of life of patients with cervical dystonia and impact of treatment with abobotulinumtoxin A (Dysport): results from a randomized, double-blind, placebo-controlled study. BMJ Open 4:e005150

    Article  PubMed  PubMed Central  Google Scholar 

  4. Albanese A, Sorbo FD, Comella C, Jinnah HA, Mink JW, Post B et al (2013) Dystonia rating scale: critique and recommendations. Mov Disord 28:874–883

    Article  PubMed  PubMed Central  Google Scholar 

  5. Consky ES, Lang AE (1994) Clinical assessments of patients with cervical dystonia. In: Jankovic J, Hallett M (eds) Therapy with Botulinum Toxin. Marcel Dekker, Inc., New York, pp 211–237

    Google Scholar 

  6. Beck AT, Steer RA, Garbin MB (1988) Psychometric properties of the Beck Depression Inventory. Twenty-five years of evaluation. Clin Psychol Rev 8:77–100

    Article  Google Scholar 

  7. Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897

    Article  CAS  PubMed  Google Scholar 

  8. Müller J, Wissel J, Kemmler G, Voller B, Bodner T, Schneider A, Austrian Botulinum Toxin and Dystonia Study Group et al (2004) Craniocervical dystonia questionnaire (CDQ-24): development and validation of a disease-specific quality of life instrument. J Neurol Neurosurg Psychiatry 75:749–753

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ware JE (2000) SF-36 health survey update. Spine 25:3130–3139

    Article  PubMed  Google Scholar 

  10. Kilbane C, Ostrem J, Galifianakis N, Grace J, Markun L, Glass GA (2012) Multichannel electromyographic mapping to optimize Onabotulinumtoxin A efficacy in cervical dystonia tremor. Other Hyperkinet Mov 2: pii tre-02-91-598-1

  11. Moraru E, Schnider P, Wimmer A, Wenzel T, Birner P, Griengl H et al (2002) Relation between depression and anxiety in dystonic patients: implications for clinical management. Depress Anxiety 16:100–103

    Article  CAS  PubMed  Google Scholar 

  12. Müller J, Kemmler G, Wissel J, Schneider A, Voller B, Grossmann J, Austrian Botulinum Toxin and Dystonia Study Group et al (2002) The impact of blepharospasm and cervical dystonia on health-related quality of life and depression. J Neurol 249:842–846

    Article  PubMed  Google Scholar 

  13. Fabbrini G, Berardelli I, Moretti G, Pasquini M, Bloise M, Colosimo C et al (2010) Psychiatric disorders in adult-onset focal dystonia: a case-control study. Mov Disord 25:459–465

    Article  PubMed  Google Scholar 

  14. Gündel H, Wolf A, Xidara V, Busch R, Ladwig KH, Jacobi F et al (2003) High psychiatric comorbidity in spasmodic torticollis: a controlled study. J Nerv Ment Dis 191:465–473

    Article  PubMed  Google Scholar 

  15. Slawek J, Friedman A, Potulska A, Krystkowiak P, Gervais C, Banach M et al (2007) Factors affecting the health-related quality of life of patients with cervical dystonia and the impact of botulinum toxin type A injections. Funct Neurol 22:95–100

    PubMed  Google Scholar 

  16. Kiss ZH, Doig-Beyaert K, Eliasziw M, Tsui J, Haffenden A, Suchowersky O (2007) The Canadian multicentre study of deep brain stimulation for cervical dystonia. Brain 130:2879–2886

    Article  PubMed  Google Scholar 

  17. Werle RW, Takeda SY, Zonta MB, Guimarães AT, Teive HA (2014) The physical, social and emotional aspects are the most affected in the quality of life of the patients with cervical dystonia. Arq Neuropsiquiatr 72:405–410

    Article  PubMed  Google Scholar 

  18. Papathanasiou I, MacDonald L, Whurr R, Jahanshahi M (2001) Perceived stigma in spasmodic torticollis. Mov Disord 16:280–285

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinical Department of Neurology, Osijek University Hospital Center, Josipa Huttlera 4, 31000, Osijek, Croatia

    Svetlana Tomic, Tomislav Pucic & Stjepan Juric

  2. School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia

    Svetlana Tomic, Ivana Petkovic, Bojan Resan & Stjepan Juric

  3. School of Engineering, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland

    Bojan Resan

  4. Clinical Department of Radiology, Osijek University Hospital Center, Osijek, Croatia

    Tatjana Rotim

Authors
  1. Svetlana Tomic
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  2. Ivana Petkovic
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  3. Tomislav Pucic
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  4. Bojan Resan
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  5. Stjepan Juric
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  6. Tatjana Rotim
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Corresponding author

Correspondence to Svetlana Tomic.

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Conflict of interest

Auth or A received honoraria from Abbvie d.o.o, Ewopharma d.o.o, Pliva Teva d.o.o., Medis d.o.o; and received financial support for attending symposia from Abbvie d.o.o. and Medis d.o.o. Author B has no conflict of interest. Author C has no conflict of interest. Author D has no conflict of interest. Author E received honoraria from Pliva Teva d.o.o. Author F has no conflict of interest.

Ethical approval

This study was performed in compliance to ethical standards.

Informed consent

All the patients gave their informed consent prior entering the study.

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Tomic, S., Petkovic, I., Pucic, T. et al. Cervical dystonia and quality of life. Acta Neurol Belg 116, 589–592 (2016). https://doi.org/10.1007/s13760-016-0634-1

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  • DOI: https://doi.org/10.1007/s13760-016-0634-1

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