Executive functioning in patients with blepharospasm in comparison with patients with hemifacial spasm

Dias, Fernando Machado Vilhena; Doyle, Flávia C P; Kümmer, Arthur; Cardoso, Francisco; Caramelli, Paulo; Teixeira, Antônio Lúcio

doi:10.1590/s0004-282x2009000100004

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…One study that tested executive functions using the frontal assessment battery in 22 patients with blepharospasm compared to 29 with hemifacial spasm did not detect any difference between the 2 groups. 52 A widespread cognitive assessment was performed by Alem an and colleagues 53 and Romano and colleagues. 54 Both studies pointed to an impairment in several specific cognitive domains that was not consistent with overt dementia but with multidomain mild cognitive impairment.…”

Section: Cognitive Dysfunctionmentioning

confidence: 99%

Blepharospasm 40 years later

et al. 2017

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Forty years ago, C.D. Marsden proposed that blepharospasm should be considered a form of adult-onset focal dystonia. In the present paper, we provide a comprehensive overview of the findings regarding blepharospasm reported in the past 40 years. Although prolonged spasms of the orbicularis oculi muscles remain the clinical hallmark of blepharospasm, patients with blepharospasm may be characterized by various types of involuntary activation of periocular muscles. In addition to motor features, blepharospasm patients may also have nonmotor manifestations, including psychiatric, mild cognitive, and sensory disturbances. The various motor and nonmotor symptoms are not present in all patients, suggesting that blepharospasm is phenomenologically a heterogeneous condition. This emphasizes the need for tools for severity assessment that take into account both motor and nonmotor manifestations. The cause of blepharospasm remains elusive, but several lines of evidence indicate that blepharospasm is a multifactorial condition in which one, or several, as yet unknown genes together with epigenetic and environmental factors combine to reach the threshold of the disease. Although blepharospasm was originally believed to be solely a basal ganglia disorder, neurophysiological and neuroimaging evidence point to anatomical and functional involvement of several brain regions. The contribution of multiple areas has led to the hypothesis that blepharospasm should be considered as a network disorder, and this might reflect the varying occurrence of motor and nonmotor manifestations in blepharospasm patients. Despite advances in the aetiology and pathophysiology, treatment remains symptomatic.

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Section: Cognitive Dysfunctionmentioning

confidence: 99%

Blepharospasm 40 years later

et al. 2017

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“…Conversely, another study of ten patients with primary dystonia, who differed in terms of body distribution, detected that patients with dystonia had significantly lower word fluency than the healthy controls, but no deficits in executive function or working memory[ 9 ]. Dias et al found that executive function, as assessed by the Frontal Assessment Battery, was not altered in primary blepharospasm (BSP) compared with hemifacial spasm[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Screening for Cognitive Impairments in Primary Blepharospasm

et al. 2016

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BackgroundsStudies have reported that non-motor symptoms are an important component of primary dystonia. However, evidence supporting cognitive impairment in primary dystonia is limited and contradictory.MethodsWe applied the Chinese version of the Addenbrooke’s Cognitive Examination-Revised and the Mini-Mental State Examination (MMSE) to screen for cognitive impairment in patients with primary blepharospasm. In addition, we investigated the relationship between performance on the Addenbrooke’s Cognitive Examination-Revised and quality of life as measured by the Medical Outcomes Study 36-item Short-Form (SF36).ResultsThe study included 68 primary blepharospasm patients and 68 controls matched by age, sex and education. The prevalence of cognitive deficits was 22.0% and 32.3% in primary blepharospasm patients group, as measured by the MMSE and the Addenbrooke’s Cognitive Examination-Revised, respectively. Primary blepharospasm patents had a broad range of cognitive deficits, with the most frequently affected domains being visuospatial function (30.9%) and language (30.9%), followed by memory (27.9%), orientation/attention (26.4%) and verbal fluency (22.0%). Patients with cognitive deficits had lower total SF36 scores, especially in the subdomains of physical functioning, role-physical and social functioning, compared to those without cognitive deficits. Scores on the Addenbrooke’s Cognitive Examination-Revised were significantly correlated with both the SF36 scores and the scores on the subdomains of physical functioning and social functioning.ConclusionsSome patients with primary blepharospasm have cognitive deficits. Poor performance on the Addenbrooke’s Cognitive Examination-Revised is related to poorer quality of life.

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“…In the current study, there was a trend for more BS patients to score in the YBOCS (Table 3). YBOCS is considered a reliable method for assessment of OCD symptoms (9). The frequency of OCD in the group of patients with BS was also remarkably high, despite the lack of statistical difference from the HS group.…”

Section: Discussionmentioning

confidence: 99%