Quality of life in cervical dystonia after treatment with botulinum toxin A: a 24-week prospective study

Abstract

ObjectiveThis study aimed to identify possible improvements in disease-specific health-related quality of life (HRQoL) after multiple injections of botulinum toxin A over 24 weeks in Thai cervical dystonia (CD) patients.Materials and methodsA 24-week prospective study comparing HRQoL of Thai CD patients before and after multiple injections of botulinum toxin A at 3-month intervals was performed. Disease-specific HRQoL was assessed by using the Cervical Dystonia Impact Profile-58 questionnaire (CDIP-58) and the Craniocervical Dystonia Questionnaire-24 (CDQ-24). General HRQoL was assessed by using the Medical Outcomes’ 36-Item Short Form Health Survey (SF-36) and the EuroQoL 5-dimension questionnaire (EQ-5D). All the assessments were performed before and after the 24-week treatment period.ResultsA total of 20 CD patients were enrolled in this study from April to December 2011. CDIP-58 and CDQ-24 scores, which assess disease-specific HRQoL, showed a significant improvement after 24 weeks of treatment by botulinum toxin A (P<0.001). However, EQ-5D and SF-36 scores, which assess general HRQoL, showed no significant improvement after the treatment (P>0.05).ConclusionCD patients’ disease-specific HRQoL improved after being treated with multiple botulinum toxin A injections. However, general HRQoL was not improved.

Quality of life improvements in patients with cervical dystonia following treatment with a liquid formulation of abobotulinumtoxinA (Dysport®)

“…[2], the first study to test the sensitivity to change of the scale following BoNT‐A treatment, and greater than that recently reported by Kongsaengdao et al . for the Thai CDIP‐58 following treatment with neubotulinumtoxinA. Importantly, improvements across all eight health domains of the CDIP‐58 were sustained after repeat treatment with ASI (52 weeks of follow‐up) in patients who entered the open‐label phase of the study.…”

Long-term quality of life in cervical dystonia after treatment with abobotulinum toxin A: a 2-year prospective study

“… 2 Another study also suggested that a 3-month fixed dose of 50 units of Neu-BTX A injections was efficacious in the treatment of such patients when measured by the Cervical Dystonia Impact Profile (CDIP-58) and Cervical Dystonia Questionnaire -24 items (CDQ-24) questionnaires. 1 Unfortunately, these short-term studies did not show improvement of general HRQoL measured by the 36-Item Short-Form Health Survey (SF-36). 1 , 2 Additionally, the remaining studies did not evaluate the quality of life.…”

“… 3 – 7 A previous study in Thai patients suggests that torticollis (horizontal turning) of the neck is the most common type, followed by laterocollis (lateral flexion or tilt of the neck), retrocollis (posterior extension of the neck), and anterocollis (forward flexion of the neck). 1 , 2 The worldwide incidence rate of CD is 0.80 per 100,000 person-years, and is predominantly observed in female patients. 8 In a European study, an estimated prevalence rate of adult-onset focal dystonia was 5.7 per 100,000 persons, while its prevalence rate in Thailand, primarily diagnosed as CD, was ~13.6 per 100,000 person-years and is predominantly found in females, especially when the patients are in their fourth to fifth decade of life.…”

“…In addition to an efficacy of treatment, it is necessary to accurately evaluate the treatment outcomes in terms of the HRQoL for those CD patients. 1 , 2 , 9 , 19 , 23 , 25 – 27 It is known that as the physical condition improves, the HRQoL improves in CD patients, which is possibly related to the improvement of vision during reading and writing, social embarrassment, pain, depression, and anxiety. 1 , 2 , 9 , 19 , 23 , 25 – 27 …”

Caregiver burden and health-related quality of life in idiopathic dystonia patients under botulinum toxin treatment: a cross-sectional study

“…These effects are strongest in the middle of the treatment cycle when BT is exerting its maximal effect. However, the BT effect on HR-QoL as measured by the SF-36 was also described as either mostly statistically insignificant (Gudex et al 1998) or nonexistent (Kongsaengdao et al 2017). Dystonia may relate to reduced HR-QoL not only in the affected patients, but also in their caregivers.…”