Relationship of Cognitive Function to Motor Symptoms and Mood Disorders in Patients With Isolated Dystonia

Foley, Jessica; Vinke, R Saman; Limousin, Patricia; Cipolotti, Lisa

doi:10.1097/wnn.0000000000000117

Cited by 32 publications

(56 citation statements)

References 28 publications

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“…In other studies [ 21 - 23 ], the presence of cognitive dysfunctions was considered to be most often significant, but without elucidating their cause. In one of these studies [ 22 ], the authors also cite previous reports suggesting that decreased cognitive performance could be secondary to the psychological impact of motor and/or mood disorders associated with dystonia. Other authors [ 24 - 28 ] have shown that psychiatric and other non-motor comorbidities have an increased prevalence and are a predictor for the quality of life in particular in cervical dystonia, even more than the severity of dystonia.…”

Section: Discussionmentioning

confidence: 99%

Non-Motor Manifestations in Idiopathic Dystonia with Focal Onset – A Pilot Study

Bajenaru¹,

Popescu-Olaru²,

Dumitrescu³

et al. 2020

JMedLife

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Recent studies emphasize an increased prevalence of non-motor symptoms in idiopathic dystonia with focal onset (IDFO), but their pathophysiological relationship is not clear. We aimed to identify the prevalence of depression and neurocognitive impairment in a group of patients with idiopathic dystonia with focal onset and their impact on the patients’ quality of life. This study represents a component of an ongoing research project – GENDYS. From the database of this project, we selected 48 patients 56.62+/-14.16 years old who have been examined clinically and using specific scales: Patient Health Questionnaire-9 (for depression), Montreal Cognitive Assessment - MoCA (for cognitive impairment), and a 5-degree analog scale for subjective perception of the severity of the disease. We conducted a descriptive cross-sectional study on patients with depression and cognition evaluated by the above-mentioned scales. We also performed a nested case-control analysis on 20 IDFO patients with and without at least moderate depression matched for age and gender; the cut-offs for depression were PHQ-9 score ≥10 and PHQ9 <5, for the depression group and the control group, respectively. The cut-off for MoCA was 26 points. 22 IDFO patients (46%) had depression; 54.5% of IDFO patients with depression had cognitive impairment, indicating a slight trend of increased cognitive impairment in those with depression compared to those without; the perception of the severity of disease was the greatest in patients with depression. Depression is more prevalent in patients with IDFO and is associated with a worse perception of the disease severity.

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Section: Discussionmentioning

confidence: 99%

Non-Motor Manifestations in Idiopathic Dystonia with Focal Onset – A Pilot Study

Bajenaru¹,

Popescu-Olaru²,

Dumitrescu³

et al. 2020

JMedLife

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“…There is a growing body of literature on the non-motor features of CD, including executive dysfunction, depression, anxiety, pain, and increased disability, decreased quality of life (7,(11)(12)(13). Those with CD display a high rate of depression or anxiety that has not previously correlated with dystonia severity (14). The main treatments in cervical dystonia are: botulinum toxin injections alone; botulinum toxin injections in combination with oral medication; and for refractory cases, deep brain stimulation (DBS) (7,15).…”

Section: Introductionmentioning

confidence: 99%

Isolated Cervical Dystonia: Management and Barriers to Care

et al. 2020

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Background: Cervical dystonia (CD) is a rare disorder, and health care providers might be unfamiliar with its presentation, thus leading to delay in the initial diagnosis. The lack of awareness displays the need to highlight the clinical features and treatment in cervical dystonia. In our cohort, we have identified an earlier age of onset in men, despite an overall preponderance of affected women.Objective: We aim to identify the prevalence, age of onset, spread, and treatment modalities of CD in the population. We also highlight the barriers which patients encounter related to diagnosis, follow-up, and treatment.Methods: We reviewed 149 CD patients who attended specialized Dystonia Clinics over a 14-year period. Dystonia severity was rated using the Burke-Fahn-Marsden (BFM), Tsui, and Toronto Western Spasmodic Torticollis Rating Scales (TWSTRS). Mood and quality of life were assessed using Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and 36-Item Short Form Health Survey (SF-36).Results: CD patients were majority White (91.3%) and more commonly female (75.8%). Men had an earlier median age of onset, 40.5 years (p = 0.044). BAI revealed a mean score of 7.2 (±6.4, n = 50) indicating minimal anxiety while BDI revealed a mean score of 7.30 (±7.6, n = 50) indicating minimal depression. The only SF-36 subscales associated with CD severity were physical functioning (p = 0.040) pain (p = 0.008) and general health (p = 0.014).Conclusion: There appear to be gender differences in both the prevalence and age of onset of the disease. There was a 3-fold higher incidence in women than in men. CD patients of both sexes experience barriers to care, which can be reflected in their quality of life and time-to-diagnosis. In addition, males were less likely to experience an objective benefit with botulinum toxin treatment and more likely to discontinue care. Greater awareness of CD by health care providers is important to reduce the time-to-diagnosis.

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“…Данные о наличии КН при ФМД неоднозначны. Одни авторы считают, что КН характерны для пациентов с ФМД [5][6][7][8][9][10], другие придерживаются противоположной точки зрения [11,12]. Такие расхождения могут быть связаны с различием нейропсихологических методов, применяемых для диагностики КН в разных исследованиях.…”

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“…Данные об ассоциации эмоциональных и когнитивных расстройств при ФМД противоречивы. В одних исследованиях наблюдалась корреляция между тяжестью депрессии и показателями управляющих функций [6,7], в других такой связи не найдено [5,9,22]. По нашим данным, депрессия ухудшает показатели управляющих функций, умеренные КН у пациентов с ФМД могут быть обусловлены наличием эмоциональных расстройств.…”

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Cognitive impairment and mental disorders in patients with focal muscular dystonia

Толмачева¹,

Grishina²,

Романов

2019

RJTAO

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1 Кафедра нервных болезней и нейрохирургии; 2 научно-исследовательский отдел психосоматической медицины Научно-технологического парка биомедицины ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава России, Москва, Россия; 3 отдел по изучению пограничной психической патологии и психосоматических расстройств ФГБНУ «Научный центр психического здоровья», Москва, Россия 1 119021, Москва, ул. Россолимо, 11, стр. 1; 2 119435, Москва, ул. Большая Пироговская, 6, стр. 1; 3 115522, Москва, Каширское шоссе, 34 При фокальной мышечной дистонии (ФМД) мало изучены недвигательные проявления. Цель исследования -анализ особенностей когнитивных (КН) и психических нарушений при ФМД. Пациенты и методы. Обследовано 15 пациентов с ФМД (7 мужчин и 8 женщин) в возрасте от 25 до 80 лет (средний возраст 59,8±14,7 года). У 10 (66,7%) пациентов отмечалась цервикальная дистония, у 5 (33,3%) -блефароспазм. Контрольную группу составили 15 здоровых лиц (7 мужчин и 8 женщин, средний возраст 58,2±14,9 года). Проводились неврологическое, стандартизированное психиатрическое обследование, нейропсихологические тесты, применялись шкала депрессии Бека и шкала тревоги Спилбергера. Результаты и обсуждение. У пациентов с ФМД выявлены умеренные КН по типу нарушения управляющих функций. Депрессия диагностирована у 9 (60%) пациентов, в большинстве случаев (n=8) она соответствовала картине затяжных психогенно провоцированных состояний. У 6 (40%) пациентов с ФМД имелись тревожные и соматизированные расстройства. Патофизиология недвигательных проявлений ФМД, вероятно, зависит от множества причин, включая связь между различными клиническими факторами и нарушением функционирования базальных ганглиев. Данные об ассоциации эмоциональных расстройств и КН при ФМД противоречивы. Психические нарушения, по-видимому, способны выступать в качестве дополнительного фактора, утяжеляющего проявления дистонии. Заключение. Умеренные КН у пациентов с ФМД могут быть обусловлены эмоциональными расстройствами, которые утяжеляют проявления заболевания. Диагностика и коррекция эмоциональных расстройств перспективны при ведении пациентов с ФМД. Ключевые слова: фокальная мышечная дистония; недвигательные расстройства; когнитивные нарушения; психические расстройства. Контакты: Виолетта Александровна Толмачева; vtolmacheva@yandex.ru Для ссылки: Толмачева ВА, Гришина ДА, Романов ДВ. Когнитивные и психические нарушения у пациентов с фокальной мышечной дистонией. Неврология, нейропсихиатрия, психосоматика. 2019;11(4):51-56. Cognitive impairment and mental disorders in patients with focal muscular dystoniaNon-motor manifestations in focal muscular dystonia (FMD) have been little studied. Objective: to analyze the characteristics of cognitive impairment (CI) and mental disorders (MDs) in FMD. Patients and methods. Fifteen patients (7 men and 8 women) aged 25 to 80 years (mean age, 59.8±14.7 years) with FMD were examined. Cervical dystonia and blepharospasm were noted in 10 (66.7%) and 5 (33.3%) patients, respectively. A c...

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Relationship of Cognitive Function to Motor Symptoms and Mood Disorders in Patients With Isolated Dystonia

Cited by 32 publications

References 28 publications

Non-Motor Manifestations in Idiopathic Dystonia with Focal Onset – A Pilot Study

Non-Motor Manifestations in Idiopathic Dystonia with Focal Onset – A Pilot Study

Isolated Cervical Dystonia: Management and Barriers to Care

Cognitive impairment and mental disorders in patients with focal muscular dystonia

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