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Open Access 01-03-2021 | Torticollis Spasticus | Neurology and Preclinical Neurological Studies - Original Article

Emotional well-being and pain could be a greater determinant of quality of life compared to motor severity in cervical dystonia

Authors: Lisa Klingelhoefer, Maximilian Kaiser, Anna Sauerbier, Robert Untucht, Miriam Wienecke, Könül Mammadova, Björn Falkenburger, Olaf Gregor, K. Ray Chaudhuri, Heinz Reichmann

Published in: Journal of Neural Transmission | Issue 3/2021

Abstract

Non-motor symptoms (NMS) occur in patients with cervical dystonia (CD) but with variable frequencies and impact on health-related quality of life (HRQoL). To define non-motor and motor profiles and their respective impact on HRQoL in CD patients using the newly validated Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest). In an observational prospective multicentre case–control study, we enrolled 61 patients with CD and 61 age- and sex-matched healthy controls (HC) comparing demographic data, motor and non-motor symptoms and HRQoL measurements. 95% CD patients reported at least one NMS. Mean total NMS score was significantly higher in CD patients (5.62 ± 3.33) than in HC (1.74 ± 1.52; p < 0.001). Pain, insomnia and stigma were the most prevalent NMS and HRQoL was significantly impaired in CD patients compared to HC. There was strong correlation of NMS burden with HRQoL (CDQ-24: r = 0.72, EQ-5D: r = − 0.59; p < 0.001) in CD patients. Regression analysis between HRQoL and NMS suggested that emotional well-being (standardized beta = − 0.352) and pain (standardized beta = − 0.291) had a major impact on HRQoL while, in contrast motor severity had no significant impact in this model. Most NMS with the exception of pain, stigma and ADL did not correlate with motor severity. NMS are highly prevalent in CD patients and occur independent of age, sex, disease duration, duration of botulinum neurotoxin therapy and socio-economic status. Specific NMS such as emotional well-being and pain have a major impact on HRQoL and are more relevant than motor severity.

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Title: Emotional well-being and pain could be a greater determinant of quality of life compared to motor severity in cervical dystonia
Authors: Lisa Klingelhoefer
Maximilian Kaiser
Anna Sauerbier
Robert Untucht
Miriam Wienecke
Könül Mammadova
Björn Falkenburger
Olaf Gregor
K. Ray Chaudhuri
Heinz Reichmann
Publication date: 01-03-2021
Publisher: Springer Vienna
Keywords: Torticollis Spasticus
Dystonia
Botulinum Toxin
Published in: Journal of Neural Transmission / Issue 3/2021
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-020-02274-z

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Emotional well-being and pain could be a greater determinant of quality of life compared to motor severity in cervical dystonia

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