Psychiatric co-morbidity is highly prevalent in idiopathic cervical dystonia and significantly influences health-related quality of life: Results of a controlled study

Smit, Marije; Kuiper, Anouk; Han, Vladimir; Jiawan, V C R; Douma, Geert; Harten, Barbera van; Oen, J.M.T.H.; Pouwels, M.E.; Dieks, H.J.G.; Bartels, Anna L.; Tijssen, Marina A. J.

doi:10.1016/j.parkreldis.2016.06.004

Cited by 81 publications

(136 citation statements)

References 23 publications

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“…In our cohort, 63% of patients had psychiatric symptoms. This is on the high end of the 17–70% range reported in observational cohort studies in the literature [6, 7, 38, 39]. Molecular imaging studies in depression and anxiety disorders have shown abnormalities in both striatal DAT and D2/3 receptor binding.…”

Section: Discussionmentioning

confidence: 91%

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The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

Zoons

Tijssen

Dreissen

et al. 2017

Eur J Nucl Med Mol Imaging

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PurposeCervical dystonia (CD) is associated with tremor/jerks (50%) and psychiatric complaints (17–70%). The dopaminergic system has been implicated in the pathophysiology of CD in animal and imaging studies. Dopamine may be related to the motor as well as non-motor symptoms of CD. CD is associated with reduced striatal dopamine D2/3 (D2/3) receptor and increased dopamine transporter (DAT) binding. There are differences in the dopamine system between CD patients with and without jerks/tremor and psychiatric symptoms.MethodsPatients with CD and healthy controls underwent neurological and psychiatric examinations. Striatal DAT and D2/3 receptor binding were assessed using [123I]FP-CIT and [123I]IBZM SPECT, respectively. The ratio of specific striatal to non-specific binding (binding potential; BPND) was the outcome measure.ResultsTwenty-seven patients with CD and 15 matched controls were included. Nineteen percent of patients fulfilled the criteria for a depression. Striatal DAT BPND was significantly lower in depressed versus non-depressed CD patients. Higher DAT BPND correlated significantly with higher scores on the Unified Myoclonus Rating Scale (UMRS). The striatal D2/3 receptor BPND in CD patients showed a trend towards lower binding compared to controls. The D2/3 BPND was significantly lower in depressed versus non-depressed CD patients. A significant correlation between DAT and D2/3R BPND was found in both in patients and controls.ConclusionsAlterations of striatal DAT and D2/3 receptor binding in CD patients are related mainly to depression. DAT BPND correlates significantly with scores on the UMRS, suggesting a role for dopamine in the pathophysiology of tremor/jerks in CD.

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Section: Discussionmentioning

confidence: 91%

“…Psychiatric complaints, mainly depressive symptoms and anxiety disorders, have been described in a significant number of patients with dystonia (17–70%) [5–7]. Lifetime prevalence of up to 91.4% has been reported [5].…”

Section: Introductionmentioning

confidence: 99%

The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

Zoons

Tijssen

Dreissen

et al. 2017

Eur J Nucl Med Mol Imaging

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“…We assessed the frequency of NMS using the NMS list proposed by Klingelhoefer et al., with the addition of a question about sexual problems (see Table ). This question was added because, in a previous part of our study about psychiatric comorbidity, several patients mentioned that they had experienced problems with sexual activities . With this questionnaire, the objective was to highlight the most frequent and burdensome NMS as a first step toward creating a validated dystonia NMS questionnaire.…”

Section: Methodsmentioning

confidence: 99%

“…The NMS questionnaire was self‐administered. In addition, based on the literature in combination with our own experience, patients were asked to score the severity of symptoms that had a high impact on HR‐QoL on a scale from zero (no complaints) to 10 (severe complaints). These symptoms included “tremor/jerks,” “sad or depressed feeling,” “feeling nervous, worried, or frightened for no apparent reason,” “sleep disturbances,” “fatigue,” and “pain not explained by other conditions.” HR‐QoL was assessed using the RAND‐36 item Health Survey (RAND‐36), which consists of 9 domains of both physical and mental health.…”

Section: Methodsmentioning

confidence: 99%

The Frequency and Self‐perceived Impact on Daily Life of Motor and Non‐motor Symptoms in Cervical Dystonia

Smit

Bartels

Kuiper

et al. 2017

Movement Disord Clin Pract

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Background Evidence suggests that non‐motor symptoms (NMS) are the most important predictors of decreased health‐related quality of life (HR‐QoL) in patients with cervical dystonia (CD). In this study, we evaluate an NMS screening list and examine the influence of motor symptoms and NMS on HR‐QoL. Methods In 40 patients with CD, the frequency of NMS was evaluated using an extended NMS questionnaire. Furthermore, patients composed a list of their 5 most burdensome motor symptoms and NMS and scored the severity of predefined symptoms. HR‐QoL was examined with the RAND 36‐item Health Survey. Results Of 40 patients, 38 experienced NMS (median number of NMS, 6.5; range, 0–13; maximum, 15). The self‐perceived most burdensome symptoms were tremor/jerks, pain, sleep disturbances, daily‐life limitations, and fatigue. Also, of the predefined symptom list, tremor and fatigue were identified as the most disturbing. Several domains of HR‐QoL were significantly influenced by NMS, whereas motor symptoms had only a small influence on the physical functioning domain of HR‐QoL. Conclusion Our findings highlight the impact of NMS on HR‐QoL and emphasize the importance of a standardized, validated NMS questionnaire for patients with dystonia. This would enable us to monitor the effect of treatment for motor symptoms and NMS on an individual basis and improve treatment options.

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“…Jerks and tremor are fast movements in contrast to phasic or mobile dystonia that consist of slower movements. Many patients with CD suffer from depressive symptoms and anxiety, with a lifetime prevalence of 40%–70% 3. CD has a serious impact on quality of life that is mainly determined by depressive symptoms 4.…”

Section: Introductionmentioning

confidence: 99%

Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor

Zoons

Booij

Delnooz

et al. 2018

J Neurol Neurosurg Psychiatry

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Psychiatric co-morbidity is highly prevalent in idiopathic cervical dystonia and significantly influences health-related quality of life: Results of a controlled study

Cited by 81 publications

References 23 publications

The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

The Frequency and Self‐perceived Impact on Daily Life of Motor and Non‐motor Symptoms in Cervical Dystonia

Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor

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