Neuropsychiatric Symptoms and Quality of Life in Patients With Adult-Onset Idiopathic Focal Dystonia and Essential Tremor

Lee, Sang-Jin; Chung, Sun Ju; Shin, Hae‐Won

doi:10.3389/fneur.2020.01030

Cited by 8 publications

(4 citation statements)

References 51 publications

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“…In addition, it is well known that neurological disorders often result in increased disability and decreased quality of life that might make patients more prone to develop psychiatric conditions and consequently to seek formal medical care for both ET and psychiatric symptom management [47][48][49][50]. In this context, the onset of new ET symptoms might encourage patients to receive a new therapy for its management.…”

Section: Discussionmentioning

confidence: 99%

Treatment patterns in essential tremor: Real‐world evidence from a United Kingdom and France primary care database

Antonazzo,

Rozza,

Conti

et al. 2023

Euro J of Neurology

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Background and purposeEssential tremor (ET) is one of the most common neurological disorders, but information on treatment pattern is still scant. The aim of this study was to describe the demographic and clinical characteristics, treatment patterns, and determinants of drug use in patients with newly diagnosed ET in France and the United Kingdom.MethodsIncident cases of ET diagnosed between January 1, 2015 and December 31, 2018 with 2 years of follow‐up were identified by using The Health Improvement Network (THIN®) general practice database. During the follow‐up, we assessed the daily prevalence of use and potential switches from first‐line to second‐line treatment or other lines of treatment. Logistic regression models were conducted to assess the effect of demographic and clinical characteristics on the likelihood of receiving ET treatment.ResultsA total of 2957 and 3249 patients were selected in the United Kingdom and France, respectively. Among ET patients, drug use increased from 12 months to 1 month prior the date of index diagnosis (ID). After ID, nearly 40% of patients received at least one ET treatment, but during follow‐up drug use decreased and at the end of the follow‐up approximately 20% of patients were still on treatment. Among treated patients, ≤10% maintained the same treatment throughout the entire follow‐up, nearly 20% switched, and 40%–75% interrupted any treatment. Results from the multivariate analysis revealed that, both in France and the United Kingdom, patients receiving multiple concomitant therapies and affected by psychiatric conditions were more likely to receive an ET medication.ConclusionThis study shows that ET is an undertreated disease with a lower‐than‐expected number of patients receiving and maintaining pharmacological treatment. Misclassification of ET diagnosis should be acknowledged; thus, results require cautious interpretation.

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Section: Discussionmentioning

confidence: 99%

Treatment patterns in essential tremor: Real‐world evidence from a United Kingdom and France primary care database

Antonazzo,

Rozza,

Conti

et al. 2023

Euro J of Neurology

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“…Our study demonstrated that 95.5% of patients with ET had at least 1 comorbidity, 79.7% had at least 3 comorbidities, and 56.9% JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH had at least 5 comorbidities. Multiple comorbidities are associated with poor health outcomes: decreased quality of life, 32,[35][36][37] increased psychological distress, 38 longer LOS, worse postoperative complications, and higher HCC and mortality. 24,[39][40][41] The interplay between multimorbidity and chronic disease is extremely important but receives inadequate attention in many chronic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…7,9 These symptoms may worsen over time and significantly impact a patient's quality of life and ability to perform activities of daily living. 2,[10][11][12] Medications used to treat ET can be moderately effective at reducing symptoms but do not treat the underlying disease. 13,14 It is estimated that only 30% to 50% of patients with ET respond to pharmacotherapy.…”

Section: Journal Of Health Economics and Outcomes Researchmentioning

confidence: 99%

Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population

Dai

Samiian²,

Fernandes

et al. 2022

JHEOR

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Background: Essential tremor (ET), the most common movement disorder, often impairs patients’ ability to perform activities of daily living, mental health, and quality of life. Objectives: To assess comorbidities, psychiatric disorders, healthcare resource utilization (HCRU), and costs among patients with ET compared with patients without ET. Methods: This retrospective observational study was conducted using a large US administrative claims database. Patients with ET were identified during the study period (1/1/2017–12/31/2019). The earliest claim date with ET diagnosis was identified as the index date. An index date was assigned randomly for each non-ET patient. Patients had to be at least 22 years old and be enrolled in the health plan for at least 6 months before and at least 12 months after the index date. Patients with and those without ET were matched 1:1 on age, gender, payer type, and first 3 digits of their ZIP code. Comorbidities were assessed using data within 6 months prior to the index date. Psychiatric disorders, HCRU, and costs were examined using data within 12 months after the index date. Results: The mean (SD) age of ET patients (n = 5286) was 70.8 (11.8) years, 49.1% were female, and 82.9% were Medicare Advantage members. In the 12 months following the index date, 26.0% of patients had no insurance claims for ET-related pharmacotherapy or invasive therapies. Patients with ET had a higher number of comorbidities than non-ET patients (5.3 [3.2] vs 4.0 [3.3]); a higher prevalence of psychiatric disorders (depression: 25.6% vs 15.3%; adjusted odds ratio (AOR) [95% CI], 1.56 [1.41-1.73]; anxiety: 27.7% vs 15.5%, AOR: 1.78 [1.61-1.96]); and higher total healthcare costs: $17 560 [$39 972] vs $13 237 [$27 098], adjusted cost ratio [95% CI]: 1.11 [1.06-1.16]; all P<.0001. Discussion: Highly prevalent multiple comorbidities and psychiatric disorders should be considered in the context of clinical decision-making to optimize ET management. Conclusions: This study represents the largest observational study to report ET disease and economic burdens in a real-world setting. The data demonstrate increased comorbidity, mental health, and healthcare cost burdens among ET patients compared with matched non-ET patients. These findings underscore the need for innovative care for this complex population.

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“…In adult-onset patients, dystonia often remains focal, whereas in pediatric-onset patients, dystonia is more likely to progress from one body region to a generalized body involvement, which may pose burden on their development and daily life [2]. Apart from motor impairment, a sizable proportion of adult-onset dystonia patients have been shown to suffer from various non-motor symptoms, such as neuropsychiatric disturbance, sleep problems, sensory disorder and cognitive decline, some of them has been found to associate with the decreased quality of life [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Non-motor symptoms in patients with isolated dystonia: comparison between the age of onset

Zhou,

Wang,

et al. 2024

Dystonia

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Background: The etiology and motor presentation differs between pediatric- and adult-onset dystonia. Emerging evidence has demonstrated that non-motor symptoms are frequent in adult dystonia, which affect the quality of life. By contrast, little is known about the frequency and severity of such presentations in pediatric-onset individuals. Here, we investigated the motor and non-motor symptoms in a large cohort of Chinese patients with isolated dystonia and compared between pediatric-onset and adult-onset groups.Methods: In this retrospective study, 34 pediatric-onset patients and 197 adult-onset patients with isolated dystonia were recruited. Motor impairment was assessed by the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Non-motor symptoms were evaluated through several validated scales, including fatigue (by Fatigue Severity Scale, FSS), excessive daytime sleepiness (by Epworth Sleepiness Scale, ESS), sleep disturbance (by Pittsburgh Sleep Quality Index, PSQI), anxiety (by Beck Anxiety Inventory, BAI) and depression (by Beck Depression Inventory 21, BDI-21).Results: Generalized dystonia was more common in pediatric-onset patients and focal dystonia was more common in adult-onset patients (p < 0.001). Generally, the BFMDRS score in total pediatric-onset group was higher than adult-onset group (p = 0.002). No differences was found in BFMDRS score between pediatric-onset and adult-onset patients with cervical and multifocal subtype dystonia. Compared with adult-onset group, pediatric-onset group had a lower rate of sleep disturbance (p < 0.0001) and similar rates of fatigue, excessive daytime sleepiness, depression and anxiety. Logistic regression analysis on patients with cervical dystonia indicated that the adult-onset and motor severity were independently associated with increased odds of sleep disturbance (p = 0.03) and depression (p = 0.01), respectively.Conclusion: Pediatric-onset dystonia patients were less likely to display focal dystonia. Most non-motor symptoms in pediatric-onset patients were comparable to their adult-onset counterparts. Non-motor presentations may to some extent correlate with motor symptoms, but their underlying pathophysiology need to be investigated further.

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Neuropsychiatric Symptoms and Quality of Life in Patients With Adult-Onset Idiopathic Focal Dystonia and Essential Tremor

Cited by 8 publications

References 51 publications

Treatment patterns in essential tremor: Real‐world evidence from a United Kingdom and France primary care database

Treatment patterns in essential tremor: Real‐world evidence from a United Kingdom and France primary care database

Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population

Non-motor symptoms in patients with isolated dystonia: comparison between the age of onset

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