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Effect of botulinum toxin on the non-motor symptoms of dystonia

E. Shakweh, R. Pearce, N. Pavese (London, United Kingdom)

Meeting: 2016 International Congress

Abstract Number: 1713

Keywords: Dystonic tremor, Non-motor Scales

Session Information

Date: Thursday, June 23, 2016

Session Title: Dystonia

Session Time: 12:00pm-1:30pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To assess the prevalence of non-motor symptoms (NMS) in patients with cervical dystonia and dystonic head tremor receiving standard botulinum toxin (BoNT) treatment and to investigate the effect of BoNT on these symptoms over the course of treatment.

Background: The full spectrum of NMS in patients with dystonia has not been extensively investigated to date. Additionally, it is unknown whether changes in the occurrence and severity of NMS occur during the 3-month course of BoNT treatment in these patients.

Methods: Three NMS questionnaires validated for Parkinson’s disease [the Non-Motor Symptom Assessment Scale for Parkinson’s disease (NMSS), the Non-motor Symptoms Questionnaire (NMS Quest), and Part 1 (non-motor aspects of daily living) of the MDS-Unified Parkinson’s disease Rating Scale (UPDRS)] were used to assess the prevalence of NMS in 23 patients with cervical dystonia and 24 patients with dystonic head tremor. The questionnaires were completed at 3 time-points; a) when patients attended the Botulinum Toxin clinic to receive their injections, b) one month after BoNT treatment and c) 2 months after BoNT treatment.

Results: Patients with cervical dystonia and dystonic head tremor had a higher total burden of NMS compared to age-matched controls, with the most significant symptom being hyperhydrosis in cervical dystonia patients (p<0.001) and low mood in dystonic head tremor patients (p<0.001). BoNT was shown to have an effect on some NMS one month after treatment, with the most important finding being a reduction in the severity of symptoms in the mood/cognition domain in patients with cervical dystonia (p=0.017). Two months after BoNT treatment, patients with cervical dystonia displayed reduced fatigue severity (p=0.046).

Conclusions: Our findings provide further evidence that non-motor symptoms are common in patients with cervical dystonia and dystonic head tremor and some of them improve with BoNT treatment. Our findings also highlight the need to develop validated scales for NMS in these disorders so that they can be reliably assessed during clinical consultations.

To cite this abstract in AMA style:

E. Shakweh, R. Pearce, N. Pavese. Effect of botulinum toxin on the non-motor symptoms of dystonia [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/effect-of-botulinum-toxin-on-the-non-motor-symptoms-of-dystonia/. Accessed October 30, 2026.
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