Skip to main content
SpringerLink
Log in

Mood and energy determinants of quality of life in dystonia

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Prior research has demonstrated that dystonia patients may have reductions in numerous measures of quality of life (QOL) when compared to healthy age-matched controls. However, the determinants of QOL in this patient population have not been fully specified. To address this issue, we administered the Medical Outcomes Study Short Form 36 (SF-36) questionnaire along with the Visual Analogue Mood Scale (VAMS), the Beck Depression Inventory (BDI), the Unified Dystonia Rating Scale (UDRS), and the State and Trait Anxiety Index (STAI) to 73 patients diagnosed with primary dystonia. Dystonia patients demonstrated lower QOL on all subscales of the SF-36 compared to normative healthy age-matched data. While the UDRS, a predominantly motor scale, was not significantly correlated with QOL (r = −0.19, P = 0.11), the BDI (r = −0.79, P < 0.0001), the STAI (r = −0.63, P < 0.0001) and multiple subscales of the VAMS revealed significant correlations. The tired subscale was the item most strongly correlated with overall QOL (r = −0.52, P < 0.0001), and particularly QOL related to physical function. The association of tiredness with QOL remained significant even when adjusting for the BDI and STAI scores (P < 0.0001). This study highlights the importance of mood and energy in QOL among a cohort of patients with dystonia. Further studies will be needed to determine the effect of treatment on these associations and whether disturbances in energy are related to sleep disturbances or to primary fatigue issues.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Beck A (1978) Beck Depression Inventory. Psychological Corp, San Antonio

    Google Scholar 

  2. Ben-Shlomo Y, Camfield L, Warner T (2002) What are the determinants of quality of life in people with cervical dystonia? J Neurol Neurosurg Psychiatry 72:608–614. doi:10.1136/jnnp.72.5.608

    Article  PubMed  CAS  Google Scholar 

  3. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164

    Article  PubMed  CAS  Google Scholar 

  4. Ceballos-Baumann AO, Passingham RE, Warner T, Playford ED, Marsden CD, Brooks DJ (1995) Overactive prefrontal and underactive motor cortical areas in idiopathic dystonia. Ann Neurol 37:363–372. doi:10.1002/ana.410370313

    Article  PubMed  CAS  Google Scholar 

  5. Chaudhuri KR, Healy DG, Schapira AH (2006) Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 5:235–245. doi:10.1016/S1474-4422(06)70373-8

    Article  PubMed  Google Scholar 

  6. Comella CL, Leurgans S, Wuu J, Stebbins GT, Chmura T (2003) Rating scales for dystonia: a multicenter assessment. Mov Disord 18:303–312. doi:10.1002/mds.10377

    Article  PubMed  Google Scholar 

  7. Dan AA, Crone C, Wise TN, Martin LM, Ramsey L, Magee S, Sjogren R, Ong JP, Younossi ZM (2007) Anger experiences among hepatitis C patients: relationship to depressive symptoms and health-related quality of life. Psychosomatics 48:223–229. doi:10.1176/appi.psy.48.3.223

    Article  PubMed  Google Scholar 

  8. Djebbari R, du Montcel ST, Sangla S, Vidal JS, Gallouedec G, Vidailhet M (2004) Factors predicting improvement in motor disability in writer’s cramp treated with botulinum toxin. J Neurol Neurosurg Psychiatry 75:1688–1691. doi:10.1136/jnnp.2003.032227

    Article  PubMed  CAS  Google Scholar 

  9. Egger K, Mueller J, Schocke M, Brenneis C, Rinnerthaler M, Seppi K, Trieb T, Wenning GK, Hallett M, Poewe W (2007) Voxel based morphometry reveals specific gray matter changes in primary dystonia. Mov Disord 22:1538–1542. doi:10.1002/mds.21619

    Article  PubMed  Google Scholar 

  10. Friedman JH, Brown RG, Comella C, Garber CE, Krupp LB, Lou JS, Marsh L, Nail L, Shulman L, Taylor CB (2007) Fatigue in Parkinson’s disease: a review. Mov Disord 22:297–308. doi:10.1002/mds.21240

    Article  PubMed  Google Scholar 

  11. Gabaldon L, Fuentes B, Frank-Garcia A, Diez-Tejedor E (2007) Poststroke depression: importance of its detection and treatment. Cerebrovasc Dis 24(Suppl 1):181–188

    PubMed  Google Scholar 

  12. Julkunen J, Ahlstrom R (2006) Hostility, anger, and sense of coherence as predictors of health-related quality of life. Results of an ASCOT substudy. J Psychosom Res 61:33–39. doi:10.1016/j.jpsychores.2005.12.005

    Article  PubMed  Google Scholar 

  13. Klepac N, Trkulja V, Relja M, Babic T (2008) Is quality of life in non-demented Parkinson’s disease patients related to cognitive performance? A clinic-based cross-sectional study. Eur J Neurol 15:128–133

    PubMed  CAS  Google Scholar 

  14. Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE (2008) Predictors of deterioration in health-related quality of life in Parkinson’s disease: results from the DATATOP trial. Mov Disord 23:653–659. doi:10.1002/mds.21853 quiz 776

    Article  PubMed  Google Scholar 

  15. Moraru E, Schnider P, Wimmer A, Wenzel T, Birner P, Griengl H, Auff E (2002) Relation between depression and anxiety in dystonic patients: implications for clinical management. Depress Anxiety 16:100–103. doi:10.1002/da.10039

    Article  PubMed  CAS  Google Scholar 

  16. Mueller J, Skogseid IM, Benecke R, Kupsch A, Trottenberg T, Poewe W, Schneider GH, Eisner W, Wolters A, Muller JU, Deuschl G, Pinsker MO, Roeste GK, Vollmer-Haase J, Brentrup A, Krause M, Tronnier V, Schnitzler A, Voges J, Nikkhah G, Vesper J, Naumann M, Volkmann J (2008) Pallidal deep brain stimulation improves quality of life in segmental and generalized dystonia: results from a prospective, randomized sham-controlled trial. Mov Disord 23:131–134. doi:10.1002/mds.21783

    Article  PubMed  Google Scholar 

  17. Muller J, Kiechl S, Wenning GK, Seppi K, Willeit J, Gasperi A, Wissel J, Gasser T, Poewe W (2002) The prevalence of primary dystonia in the general community. Neurology 59:941–943

    PubMed  CAS  Google Scholar 

  18. Page D, Butler A, Jahanshahi M (2007) Quality of life in focal, segmental, and generalized dystonia. Mov Disord 22:341–347. doi:10.1002/mds.21234

    Article  PubMed  Google Scholar 

  19. Rinnerthaler M, Benecke C, Bartha L, Entner T, Poewe W, Mueller J (2006) Facial recognition in primary focal dystonia. Mov Disord 21:78–82. doi:10.1002/mds.20659

    Article  PubMed  Google Scholar 

  20. Scott RB, Gregory R, Wilson J, Banks S, Turner A, Parkin S, Giladi N, Joint C, Aziz T (2003) Executive cognitive deficits in primary dystonia. Mov Disord 18:539–550. doi:10.1002/mds.10399

    Article  PubMed  Google Scholar 

  21. Senol V, Soyuer F, Arman F, Ozturk A (2007) Influence of fatigue, depression, and demographic, socioeconomic, and clinical variables on quality of life of patients with epilepsy. Epilepsy Behav 10:96–104. doi:10.1016/j.yebeh.2006.08.006

    Article  PubMed  Google Scholar 

  22. Sforza E, Montagna P, Defazio G, Lugaresi E (1991) Sleep and cranial dystonia. Electroencephalogr Clin Neurophysiol 79:166–169. doi:10.1016/0013-4694(91)90135-Q

    Article  PubMed  CAS  Google Scholar 

  23. Sharma P, Gupta N (2002) Social phobia in spasmodic torticollis: some conceptual issues. J Neurol Neurosurg Psychiatry 73:461. doi:10.1136/jnnp.73.4.461 author reply 461-462

    Article  PubMed  CAS  Google Scholar 

  24. Skogseid IM, Malt UF, Roislien J, Kerty E (2007) Determinants and status of quality of life after long-term botulinum toxin therapy for cervical dystonia. Eur J Neurol 14:1129–1137. doi:10.1111/j.1468-1331.2007.01922.x

    Article  PubMed  CAS  Google Scholar 

  25. Slawek J, Friedman A, Potulska A, Krystkowiak P, Gervais C, Banach M, Ochudlo S, Budrewicz S, Reclawowicz D, Rynkowski M, Opala G (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 

  26. Spielberg C, Gorsuch R, Lushene R (1983) Manual for the State-Trait Anxiety Inventory. Consulting Psychologist Press, Palo Alto

    Google Scholar 

  27. Stern RA (1996) Assessment of mood states in neurodegenerative disease: methodological issues and diagnostic recommendations. Semin Clin Neuropsychiatry 1:315–324

    PubMed  Google Scholar 

  28. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483. doi:10.1097/00005650-199206000-00002

    Article  PubMed  Google Scholar 

  29. Wenzel T, Schnider P, Wimmer A, Steinhoff N, Moraru E, Auff E (1998) Psychiatric comorbidity in patients with spasmodic torticollis. J Psychosom Res 44:687–690. doi:10.1016/S0022-3999(97)00229-8

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by the American Academy of Neurology Foundation Corporate Roundtable Clinical Research Training Fellowship, Shands Hospital, the University of Florida College of Medicine, the University of Florida National Parkinson’s Disease Foundation Center of Excellence, and the McKnight Brain Institute. The authors would also like to acknowledge Leah Gaspari for assistance in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurology, University of Florida, Gainesville, FL, USA

    Anne Soeder, Charles E. Jacobson, Ramon L. Rodriguez & Hubert H. Fernandez

  2. Departments of Neurology and Psychiatry, University of Colorado, Academic Office 1, Mailstop B185, PO Box 6511, Aurora, CO, 80045, USA

    Benzi M. Kluger

  3. Departments of Neurology, Neurosurgery, Psychiatry and History, University of Florida, Gainesville, FL, USA

    Michael S. Okun

  4. Department of Educational Psychology, University of Florida, Gainesville, FL, USA

    Cynthia W. Garvan

  5. Clinformatics, Cary, NC, USA

    Thomas Soeder

  6. Department of Clinical Research, Campbell University, Buies Creek, NC, USA

    Rick Turner

Authors
  1. Anne Soeder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Benzi M. Kluger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael S. Okun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cynthia W. Garvan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas Soeder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Charles E. Jacobson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ramon L. Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rick Turner
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hubert H. Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benzi M. Kluger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soeder, A., Kluger, B.M., Okun, M.S. et al. Mood and energy determinants of quality of life in dystonia. J Neurol 256, 996–1001 (2009). https://doi.org/10.1007/s00415-009-5060-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-009-5060-3

Keywords

Search

Navigation