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Evaluation of non-motor symptoms in cervical dystonia, hemifacial spasm, and blepharospasm patients and their correlation with motor symptoms

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Abstract

Background

Awareness of non-motor symptoms has been increasing in recent years, but there are still few studies on this topic.

Objective

Our aim was to evaluate various non-motor symptoms, especially psychiatric disorders, cognitive status, and sleep, in cervical dystonia (CD), hemifacial spasm (HFS), and blepharospasm (BPS) patients and to investigate whether these symptoms are related to the severity of motor symptoms.

Methods

This was a single-center cross-sectional, observational, case–control study. Motor severity scales were used to determine disease severity. We evaluated non-motor symptoms with commonly used scales. A total of 73 patients and 73 control groups participated.

Results

In CD patients, the MoCA total score, ‘language’, ‘abstraction’, and ‘orientation’ scores were statistically significantly lower; PSQI, ESS, and NMSQ scores were statistically significantly higher than controls. In the BPS group, the MoCA total score and the ‘language’ score were significantly lower, and the NMSQ score was statistically significantly higher than the controls. In the HFS group, MoCA total score, ‘executive functions’, ‘language’, and ‘abstraction’ scores were statistically significantly lower; PSQI scores are statistically significantly higher than controls. There was a positive correlation between the severity score and the PSQI score in the CD group and between the severity score and the NMSQ score in the BPS group. All three groups had significant cognitive impairments.

Conclusions

In CD, BPS, and HFS, non-motor symptoms are apparent with undeniable frequency in addition to common motor symptoms. Importantly, these NMS may cause significant deterioration in the quality of life of the patients.

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Data availability

The data of the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

BAI:

The Beck Anxiety Inventory

BDI:

The Beck Depression Inventory

BPS:

Blepharospasm

Btx:

Botulinum toxin

CD:

Cervical Dystonia

ESS:

The Epworth Sleepiness Scale

HFS:

Hemifacial spasm

JRS:

Jankovic Rating Scale

MoCA:

Montreal Cognitive Assessment

NMS:

Non-motor symptoms

NMSQ:

The Non-Motor Symptoms Questionnaire

PSQI:

Pittsburgh Sleep Quality Index

TWSTRS:

Toronto Western Spasmodic Torticollis Rating Scale

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Authors and Affiliations

  1. Neurology Clinic of Ankara City Hospital, Üniversiteler Mahallesi 1604, Cadde No: 9, Çankaya/Ankara, Turkey, 06800

    Hanife Nihan Yilmaz & Sule Bilen

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  1. Hanife Nihan Yilmaz
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Correspondence to Sule Bilen.

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Yilmaz, H.N., Bilen, S. Evaluation of non-motor symptoms in cervical dystonia, hemifacial spasm, and blepharospasm patients and their correlation with motor symptoms. Neurol Sci 44, 4077–4086 (2023). https://doi.org/10.1007/s10072-023-07055-6

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