Objective: To assess the extent of non-motor symptoms (NMS) in Cervical Dystonia (CD) and investigate the interaction between NMS, kinematic metrics of motor severity, and health-related quality of life (HRQoL).
Background: NMS are prominent in CD and include neuropsychiatric symptoms, sleep impairment, pain, and fatigue. Multiple studies have demonstrated a high prevalence of NMS and a clear impact on HRQoL. However, the relationship between NMS and motor severity in CD remains ambiguous, as well as how these factors interact to affect HRQoL.
Method: CD subjects were recruited at least 3 months after their last botulinum toxin injection and compared with controls. NMS were measured using the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Scale (HARS), Pittsburgh Sleep Quality Index (PSQI) and the TWSTRS-2 Pain sub-scale. Kinematic metrics included peak velocity, amplitude, and smoothness of voluntary head turns, and the range and total cumulative extent of involuntary movement. HRQoL was measured using the Cervical Dystonia Impact Profile-58 (CDIP-58).
Results: 44 CD and 33 control subjects were enrolled. CD subjects showed significantly higher depression (p<0.001), anxiety (p<0.001), sleep impairment (p=0.002) and pain (p<0.001) scores. CDIP-58 was most strongly associated with pain (r=0.78, p<0.001) and HDRS (r=0.6, p<0.001), showing weaker correlations with HARS, PSQI, and involuntary movement. Kinematic metrics correlated with pain (smoothness-pain r=-0.4, p=0.02; cumulative involuntary movement-pain r=0.43, p=0.01), but not with other NMS scores.
Conclusion: Our study confirms the high burden of NMS in CD. The relationship between NMS, motor severity, and HRQoL is complex. Our data suggests that pain and depression have the highest impact on HRQoL. Motor severity and NMS severity appear to be relatively independent, with the exception of weak associations between kinematic metrics and pain. Multivariate analysis of a larger cohort is needed to properly explore these interactions.
To cite this abstract in AMA style:
T. Hart, L. Heideman, D. Martino, M. Beudel, A. Sadnicka, F. Morgante. Relationship Between Non-Motor Symptoms, Kinematic Features, and Quality of Life in Cervical Dystonia [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/relationship-between-non-motor-symptoms-kinematic-features-and-quality-of-life-in-cervical-dystonia/. Accessed May 9, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-non-motor-symptoms-kinematic-features-and-quality-of-life-in-cervical-dystonia/