Objective: To compare DNMSQuest scores with validated measures of mood disorder in cervical dystonia patients attending a hospital botulinum toxin clinic. We wished to determine whether DNMSQuest can reliably detect mood disorder in this population.
Background: The importance of non-motor symptoms in cervical dystonia has been confirmed by a growing body of evidence. Anxiety and depression, seen in nearly 40% of patients are important predictors of quality of life. There is no robust rating scale for assessment of non-motor phenomena. The Dystonia Non Motor Symptoms Questionnaire (DNMSQuest) is a 14 item questionnaire incorporating fatigue, sleep, sensory symptoms, autonomic symptoms, stigma, emotional well-being and activities of daily living. It was designed as a brief but comprehensive assessment measure of non-motor symptoms.
Method: In 88 cervical dystonia patients (69% women), we compared scores from DNMSQuest with the Beck Anxiety Inventory (BAI), Beck Depression Index (BDI) and Hospital Anxiety and Depression Scores (HADS-A & HADS-D). We performed Spearman Rank Correlation and receiver operator characteristic (ROC) curve to identify correlation co-efficient (r), sensitivity and specificity of DNMSQuest in identifying anxiety and depression.
Results: There was a strong correlation between DNMSQuest and BAI (r=0.62), BDI (r=0.62) and HADS-D (r=0.735) and HADS-A (r=0.62). Area under ROC curve (AUC) values for DNMS were 0.824 for BDI, 0.858 for BAI, 0.803 HADS- A and 0.845 for HADS-D. DNMSQuest cut-off values between 4 and 6 provided sensitivities over 70%, but had low specificity for anxiety and depression.
Conclusion: The ideal screening instrument for non-motor symptoms would be a short, comprehensive questionnaire with high sensitivity. It may not be practical to perform HADS, BAI and BDI assessments on every patient with cervical dystonia. The DNMSQuest appears to be a sensitive initial screening method for detecting mood disorders. Based on the outcome, physicians can further clarify using more specific tools.
To cite this abstract in AMA style:
S. Rafee, S. O'Riordan, M. Hutchinson. DNMSQuest: a simple tool for identifying mood disorders in cervical dystonia? [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/dnmsquest-a-simple-tool-for-identifying-mood-disorders-in-cervical-dystonia/. Accessed May 16, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/dnmsquest-a-simple-tool-for-identifying-mood-disorders-in-cervical-dystonia/