Longitudinal predictors of health-related quality of life in isolated dystonia
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Published:2023-10-15
Issue:2
Volume:271
Page:852-863
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ISSN:0340-5354
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Container-title:Journal of Neurology
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language:en
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Short-container-title:J Neurol
Author:
Junker Johanna, Hall James, Berman Brian D., Vidailhet Marie, Roze Emmanuel, Bäumer Tobias, Malaty Irene A., Shukla Aparna Wagle, Jankovic Joseph, Reich Stephen G., Espay Alberto J., Duque Kevin R., Patel Neepa, Perlmutter Joel S., Jinnah H. A., Brandt Valerie, Brüggemann NorbertORCID,
Abstract
Abstract
Objective
To determine longitudinal predictors of health-related quality of life (HR-QoL) in an international multicenter cohort of patients with isolated dystonia.
Methods
Out of 603 dystonia patients prospectively enrolled in the Natural History Dystonia Coalition study, 155 were assessed three times within 2 years for HR-QoL, symptoms of depression, generalized anxiety disorder (GAD), and social anxiety disorder (SAD), as well as dystonia severity and dystonic tremor. In addition, the impact of botulinum neurotoxin (BoNT) injections on HR-QoL was evaluated after 1 year.
Results
Depressive symptoms at baseline predicted lower HR-QoL on all subscales after 2 years (all p ≤ 0.001). Higher GAD scores at baseline predicted lower HR-QoL related to general health, pain and emotional well-being, whereas higher SAD scores predicted higher pain-related QoL after 2 years (all p ≤ 0.006). Dystonia severity at baseline predicted social functioning (p = 0.002). Neither dystonic tremor, age, or sex predicted HR-QoL at 2 years. Two latent categories were revealed across the three-time points: Category 1 with higher total HR-QoL scores (mean HR-QoL = 74.4% ± 16.1), susceptible to symptoms of depression and SAD, and Category 2 with lower total HR-QoL scores (mean HR-QoL = 45.5% ± 17.6), susceptible to symptoms of GAD. HR-QoL improved over the course of 1 year irrespective of the use of BoNT.
Conclusion
The longitudinal impact of psychiatric symptoms on HR-QoL emphasizes the importance of incorporating mental health treatment, in particular also the therapy of anxiety disorders, into treatment regimens for dystonia.
Funder
National Center for Advancing Translational Sciences National Institute of Neurological Disorders and Stroke Universität zu Lübeck
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),Neurology
Reference43 articles.
1. Bailey GA, Martin E, Peall KJ (2022) Cognitive and Neuropsychiatric Impairment in Dystonia. Curr Neurol Neurosci Rep 22:699–708. https://doi.org/10.1007/s11910-022-01233-3 2. Berman BD, Junker J, Shelton E, Sillau SH, Jinnah HA, Perlmutter JS, Espay AJ, Jankovic J, Vidailhet M, Bonnet C, Ondo W, Malaty IA, Rodríguez R, McDonald WM, Marsh L, Zurowski M, Bäumer T, Brüggemann N (2017) Psychiatric associations of adult-onset focal dystonia phenotypes. J Neurol Neurosurg Psychiatry 88:595–602. https://doi.org/10.1136/jnnp-2016-315461 3. Slawek J, Friedman A, Potulska A, Krystkowiak P, Gervais C, Banach M, Ochudlo S, Budrewicz S, Reclawowicz D, Rynkowski M, Opala G (2007) Factors affecting the health-related quality of life of patients with cervical dystonia and the impact of botulinum toxin type A injections. Funct Neurol 22:95–100 4. Lewis L, Butler A, Jahanshahi M (2008) Depression in focal, segmental and generalized dystonia. J Neurol 255:1750–1755. https://doi.org/10.1007/s00415-008-0020-x 5. Gundel H, Wolf A, Xidara V, Busch R, Ceballos-Baumann AO (2001) Social phobia in spasmodic torticollis. J Neurol Neurosurg Psychiatry 71:499–504
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