Anxiety-depressive spectrum disorders in cervical dystonia

Abstract

A decrease in the quality of life (QoL) in cervical dystonia (CD) is often due to anxiety and depressive manifestations. However, the change in the emotional state of patients with CD after botulinum therapy has not been studied enough.Objective: a comparative analysis of the severity of anxiety and depressive disorders in CD and their dynamics during the year with a decrease in movement disorders during botulinum therapy.Patients and methods. 25 patients with CD (9 men and 16 women) and 25 healthy volunteers (11 men and 14 women) were examined. The severity of CD was assessed using the Tsui Rating Scale. To assess the level of anxiety, the GAD-7 scales were used, depression – PHQ-9. The EQ-5D questionnaire was used to assess the quality of life. The emotional state was assessed before and after 4, 8 and 12 months of the correction of movement disorders using botulinum therapy. The control group was examined at similar time intervals.Results and discussion. Patients with CD have a significant increase in anxiety (13.5±3.6) and depression (7.72±5.2), as well as a decrease in QoL (66.6±11.0) compared with the control group (p<0.001). Anxiety symptoms show a significant dependence on the clinical severity of CD symptoms and regress against the background of successful botulinum therapy – from 13.50±3.6 at the time of the first visit to 8.20±2.9 (p<0.001) by the fourth visit. Depressive symptoms do not depend on the motor manifestations of CD and do not improve as a result of successful botulinum therapy, tending to increase from 7.72±5.2 to 10.12±5.8 (p<0.05).Conclusion. The persistence of depression after successful botulinum therapy in CD indicates its role as an emotional manifestation of the disease independent of motor disorders.

Keywords

• muscular dystonia
• cervical dystonia
• motor and non-motor symptoms
• anxiety and depressive disorders