Clinical variety of affective, sleep and motor manifestations in craniocervical dystonia (a literature review)

Recent research data literature indicates the presence of non-motor symptoms in patients with dystonia such as mood disorders, cognitive impairments, sleep disturbances, autonomic dysfunction and / or pain, which are important components of quality of life. The article discusses possible comorbidity of affective manifestations,sleep disorders and dystonia. Currently, evidence is controversial, and the question requires further study. Affective symptoms and sleep disturbances of dystonia are now recognized as the greater determinant of quality of life in dystonia, being associated with health and disability, although their contribution to the clinical picture of the disease often remains underestimated. It becomes important to identify these manifestations, assess their severity and impact on the daily activity of patients with craniocervical dystonia.

ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH CRANIOCERVICAL DYSTONIA: CLINICAL AND ANAMNESTIC FEATURES AND MODIFYING ROLE OF BOTULINUM TOXIN THERAPY

The study included 54 patients with cranio-cervical dystonia, 38 (70.4%) of whom were women, 16 (29.6%) - men, mean age 49,8 ± 11,3 years. 32 patients were diagnosed with cervical dystonia, groups with blepharospasm and Meige’s syndrome included 11 patients respectively. All patients were screened by «Unified Dystonia Rating Scale» and those who had cervical dystonia also by «Toronto western spasmodic torticollis rating scale (TWSTRS)». Psychoemotional state in these patients was examined by Beck depression inventory (BDI) and Hamilton’s anxiety rating scale (HAM-A). Depression and anxiety occurrence and severity was evaluated, impact of different factors including Botulinum toxin treatment was observed. Results of the study confirmed that anxiety and depressive disorders are associated with craniocervical dystonia. Sex, localization of dystonia, disease duration, and satisfaction with the treatment do not affect significantly severity of anxiety and depression. Regular injections of Botulinum toxin significantly decrease severity of psychoemotional disorders in these patients.