Objective: To evaluate changes in depression,anxiety,pain, and quality of life alongside motor improvement in patients with dystonia treated with botulinum toxin(BoNT).

Background: Dystonia is a chronic movement disorder that can impair daily functioning and quality of life, and non-motor symptoms (anxiety, depression, pain) may contribute substantially to disability. BoNT is an established symptomatic therapy for dystonia-related motor symptoms; however, data on short-term changes in mood and quality of life after treatment in routine clinical practice remain limited.

Method: In this prospective pre–post study, 24 patients with dystonia treated with BoNT at a neurology outpatient clinic (Haydarpaşa Numune Hospital) were assessed immediately before treatment and at 1 month post-treatment. Motor severity/duration was measured with the Unified Dystonia Rating Scale (UDRS; 14 body regions). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS), and quality of life with the SF-36. Pre–post differences were analyzed, and exploratory analyses evaluated the effects of age, sex, and disease duration on baseline values and change scores, as well as relationships between changes in mood and SF-36 subdomains.

Results: N=24 (19 women/5 men), mean age 59.8±12.3 years, mean disease duration 8.4±6.8 years. UDRS total decreased from 11.521 to 3.87 at 1 month (p<0.05). Longer disease duration was associated with a greater reduction in UDRS (p<0.05). HADS-Depression changed from 7.167±4.62 to 6.63±3.03 (p<0.05) and HADS-Anxiety from 7.71±4.29 to 6.33±3.17 (p<0.05). Age was not associated with baseline scores or changes. By sex, only the SF-36 Mental Health subscale improved more in men (p=0.017). A reduction in HADS-Depression was associated with increases in SF-36 Physical Functioning and General Health subscales (p=0.036).

Conclusion: In this single-center 1-month pre–post cohort, BoNT was associated with marked motor improvement and statistically significant improvements in anxiety and depression, with selected quality-of-life gains. Mood/QoL changes were not fully explained by motor improvement alone, supporting routine screening and integrated management of non-motor symptoms in dystonia care. Short follow-up and the absence of a control group limit causal inference; larger controlled studies with longer follow-up are needed

References: This work was submitted to ADPD 2026 and has not been published to date.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-botulinum-toxin-therapy-on-depression-anxiety-pain-and-quality-of-life-in-patients-with-dystonia/