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Trinchillo A, Iorillo F, De Joanna G, Habetswallner F, Esposito M. The impact of the reclusion on patients with blepharospasm during the COVID19 pandemic. Clin Neurol Neurosurg 2022; 221:107363. [PMID: 35907350 PMCID: PMC9270186 DOI: 10.1016/j.clineuro.2022.107363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/11/2022] [Accepted: 07/08/2022] [Indexed: 11/29/2022]
Abstract
Background Blepharospasm (BS) is a focal dystonia that can be treated successfully with Botulinum toxin (BoNT). During the reclusion due to the Covid 19 pandemic many patients missed the scheduled treatment. Objectives Aim of the study is to evaluate Level of Disability (LoD) related to BS during the lockdown period. Methods LoD was assessed by an adapted version of Blepharospasm Disability Index (4iBSDI) during reclusion (T1), and three months after the first injection following the lock down phase (T2). 4iBSDI scores were compared between T1 and T2, a correlation between the change of LoD in the two periods (t-delta) and patients’ clinical data was analyzed. Results LoD was not modified between the two periods in most of the patients and it was reduced at T1 in almost one third of the participants. No correlation between t-delta and clinical data was found. Conclusions LoD did not increase during the lock down period in most of BS patients although BoNT treatment was suspended. Environmental and psychosocial factors may contribute to determine the LoD due to BS.
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Affiliation(s)
- Assunta Trinchillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, "Federico II" University, Naples, Italy
| | - Filippo Iorillo
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy
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The prevalence of depression in adult onset idiopathic dystonia: Systematic review and metaanalysis. Neurosci Biobehav Rev 2021; 125:221-230. [PMID: 33662441 DOI: 10.1016/j.neubiorev.2021.02.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
Adult onset idiopathic dystonia (AOID) is the third most common movement disorder in adults. Co-existing depressive symptoms and disorders represent major contributors of disability and quality of life in these patients, but their prevalence remains unclear. We investigated the point prevalence of supra-clinical threshold depressive symptoms/depressive disorders in AOID in a systematic review with qualitative synthesis and meta-analysis. Our search identified 60 articles suitable for qualitative synthesis and 54 for meta-analysis. The overall pooled prevalence of either supra-clinical threshold depressive symptoms or depressive disorders was 31.5 % for cervical dystonia, 29.2 % for cranial dystonia, and 33.6 % for clinical samples with mixed forms of AOID. Major depressive disorder was more prevalent than dysthymia in cervical dystonia, whereas dysthymia was more prevalent in cranial dystonia. In cervical dystonia, the prevalence of supra-clinical threshold depressive symptoms screened by rating scales was higher than that of depressive disorders diagnosed with structured interviews. Prevalence studies using rating scales yielded higher heterogeneity. More research is warranted to standardize screening methodology and characterization of mood disorders in AOID.
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Santangelo G, D'Iorio A, Peluso S, Mautone G, Vitale C, Manganelli F, Ruggiero L, Esposito M. Personality traits associated with blepharospasm: A comparison with healthy subjects, patients with facial hemispasm and patients with hyperhidrosis. J Clin Neurosci 2020; 74:130-134. [PMID: 32067829 DOI: 10.1016/j.jocn.2020.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/10/2020] [Indexed: 12/01/2022]
Abstract
The aim of this study is to explore the existence of specific personality traits related to patients with blepharospasm (BSP), treated with injections of botulinum neurotoxin (BTX). Sixteen patients with BSP, 22 with facial hemispasm (HFS), 20 with essential hyperhidrosis (EH) and 20 healthy controls (HCs) completed the Temperament and Character Inventory-Revised to explore personality traits based on Cloninger's Psychobiological Model. The results revealed that the four groups differed on the Harm Avoidance (HA) scale and fear of uncertainty subscale, as well as on Persistence (PS). On HA, BSP group did not differ from HCs, but had higher scores than HFS and EH groups. On PS scales, BSP and HFS patients did not differ between them but showed higher score than HCs and EH patients. Our findings suggested that a high level of Harm Avoidance and Persistence seem to be associated with BSP, when compared with any disorders treated with BTX. An evaluation of the personality traits might help the clinicians to early identify BSP patients at greater risk of developing psychopathological disturbances.
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Affiliation(s)
- Gabriella Santangelo
- Neuropsychology and Memory Clinic, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy.
| | - Alfonsina D'Iorio
- Neuropsychology and Memory Clinic, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Silvio Peluso
- Department of Neuroscience, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - Giusi Mautone
- Neuropsychology and Memory Clinic, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Carmine Vitale
- Department of Motor Sciences and Wellness, University "Parthenope", Naples, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - Lucia Ruggiero
- Department of Neuroscience, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - Marcello Esposito
- Department of Neuroscience, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
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Huang XF, Zhu MR, Shan P, Pei CH, Liang ZH, Zhou HL, Ni MF, Miao YW, Xu GQ, Zhang BW, Luo YY. Multiple Neural Networks Malfunction in Primary Blepharospasm: An Independent Components Analysis. Front Hum Neurosci 2017; 11:235. [PMID: 28539879 PMCID: PMC5423973 DOI: 10.3389/fnhum.2017.00235] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/24/2017] [Indexed: 01/28/2023] Open
Abstract
Primary blepharospasm (BPS) is a focal dystonia characterized by involuntary blinking and eyelid spasms. The pathophysiology of BPS remains unclear. Several neuroimaging studies have suggested dysfunction of sensory processing and sensorimotor integration, but the results have been inconsistent. This study aimed to determine whether patients with BPS exhibit altered functional brain connectivity and to explore possible correlations between these networks and clinical variables. Twenty-five patients with BPS and 25 healthy controls were enrolled. We found that the patient group exhibited decreased connectivity within the sensory-motor network (SMN), which involved regions of the bilateral primary sensorimotor cortex, supplementary motor area (SMA), right premotor cortex, bilateral precuneus and left superior parietal cortex. Within the right fronto-parietal network, decreased connections were observed in the middle frontal gyrus, dorsal lateral prefrontal cortex and inferior frontal gyrus. Regarding the salience network (SN), increased connectivity was observed in the left superior frontal gyrus and middle frontal gyrus. These findings suggest the involvement of multiple neural networks in primary BPS.
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Affiliation(s)
- Xiao-Feng Huang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Meng-Ru Zhu
- Department of Seven Year System, China Medical UniversityShenyang, China
| | - Ping Shan
- VIP Ward, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Chen-Hui Pei
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Zhan-Hua Liang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Hui-Ling Zhou
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Ming-Fei Ni
- Department of Image, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Yan-Wei Miao
- Department of Image, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Guo-Qing Xu
- Department of Psychology, Dalian Medical UniversityDalian, China
| | - Bing-Wei Zhang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
| | - Ya-Yin Luo
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical UniversityDalian, China
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Defazio G, Hallett M, Jinnah HA, Conte A, Berardelli A. Blepharospasm 40 years later. Mov Disord 2017; 32:498-509. [PMID: 28186662 DOI: 10.1002/mds.26934] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/15/2016] [Accepted: 12/19/2016] [Indexed: 01/04/2023] Open
Abstract
Forty years ago, C.D. Marsden proposed that blepharospasm should be considered a form of adult-onset focal dystonia. In the present paper, we provide a comprehensive overview of the findings regarding blepharospasm reported in the past 40 years. Although prolonged spasms of the orbicularis oculi muscles remain the clinical hallmark of blepharospasm, patients with blepharospasm may be characterized by various types of involuntary activation of periocular muscles. In addition to motor features, blepharospasm patients may also have nonmotor manifestations, including psychiatric, mild cognitive, and sensory disturbances. The various motor and nonmotor symptoms are not present in all patients, suggesting that blepharospasm is phenomenologically a heterogeneous condition. This emphasizes the need for tools for severity assessment that take into account both motor and nonmotor manifestations. The cause of blepharospasm remains elusive, but several lines of evidence indicate that blepharospasm is a multifactorial condition in which one, or several, as yet unknown genes together with epigenetic and environmental factors combine to reach the threshold of the disease. Although blepharospasm was originally believed to be solely a basal ganglia disorder, neurophysiological and neuroimaging evidence point to anatomical and functional involvement of several brain regions. The contribution of multiple areas has led to the hypothesis that blepharospasm should be considered as a network disorder, and this might reflect the varying occurrence of motor and nonmotor manifestations in blepharospasm patients. Despite advances in the aetiology and pathophysiology, treatment remains symptomatic. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Giovanni Defazio
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro", University of Bari, Bari, Italy
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Hyder A Jinnah
- Departments of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Antonella Conte
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, IS, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, IS, Italy
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Torres JAKL, Rosales RL. Nonmotor Symptoms in Dystonia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:1335-1371. [DOI: 10.1016/bs.irn.2017.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Perozzo P, Salatino A, Cerrato P, Ricci R. Sexual Well-Being in Patients with Blepharospasm, Spasmodic Torticollis, and Hemifacial Spasm: A Pilot Study. Front Psychol 2016; 7:1492. [PMID: 27761118 PMCID: PMC5050215 DOI: 10.3389/fpsyg.2016.01492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/16/2016] [Indexed: 11/23/2022] Open
Abstract
Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson's disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available.
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Affiliation(s)
| | - Adriana Salatino
- SAMBA (SpAtial, Motor & Bodily Awareness) Research Group, Psychology Department, University of Turin, TurinItaly
| | - Paolo Cerrato
- Stroke Unit, Department of Neuroscience, University of Turin, TurinItaly
| | - Raffaella Ricci
- SAMBA (SpAtial, Motor & Bodily Awareness) Research Group, Psychology Department, University of Turin, TurinItaly
- Neuroscience Institute of Turin, University of Turin, TurinItaly
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Shen CY, Wang YJ, Zhang XQ, Liu XM, Ren XJ, Ma XY, Sun JJ, Feng K, Sun GX, Xu B, Liu PZ. Prefrontal Hemodynamic Functions during a Verbal Fluency Task in Blepharospasm Using Multi-Channel NIRS. PLoS One 2016; 11:e0150804. [PMID: 26942579 PMCID: PMC4778802 DOI: 10.1371/journal.pone.0150804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 02/01/2016] [Indexed: 11/19/2022] Open
Abstract
Blepharospasm (BSP) has a morbidity of 16 to 133 per million and is characterized by orbicularis oculi spasms. BSP can severely impact daily life. However, to date, its pathophysiology has not been clearly demonstrated. Near-infrared spectroscopy (NIRS) is a portable, non-invasive, and high time resolution apparatus used to measure cerebral blood flow. This study aimed to investigate the hemodynamic response patterns of BSP patients and determine whether BSP alone can be an attributional factor to influence the function of the prefrontal area using a verbal fluency task (VFT) and NIRS. Twenty-three BSP patients (10 males and 13 females) and 13 healthy controls (HC; five males and eight females) matched by gender and education were examined using NIRS. BSP patients were divided into two groups based on the presence or absence of depression and anxiety symptoms. A covariance analysis was conducted to analyze differences between the three groups and reduce the influence of different ages and educational levels. Bonferroni was used to process the post hoc test. The bilateral orbitofrontal area (ch36, 39, and 41; P<0.01) exhibited a lower activation in BSP patients without psychiatric symptoms compared with HC. This study is the first report to identify the prefrontal function in BSP using NIRS. Our findings indicate that BSP alone may cause a hypoactive hemodynamic performance in the prefrontal cortex in the absence of psychiatric symptoms. These findings provide evidence to support novel pathophysiological mechanisms of BSP.
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Affiliation(s)
- Chen-Yu Shen
- Medical Center, Tsinghua University, Beijing, China
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Yong-Jun Wang
- YuQuan Hospital, Tsinghua University, Beijing, China
- Tianjin Anding Hospital, Tianjin, China
| | | | - Xiao-Min Liu
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Xia-Jin Ren
- Medical Center, Tsinghua University, Beijing, China
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Xiang-Yun Ma
- Medical Center, Tsinghua University, Beijing, China
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Jing-Jing Sun
- Medical Center, Tsinghua University, Beijing, China
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Kun Feng
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Gao-Xiang Sun
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Bo Xu
- YuQuan Hospital, Tsinghua University, Beijing, China
| | - Po-Zi Liu
- YuQuan Hospital, Tsinghua University, Beijing, China
- * E-mail:
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10
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Lehn A, Mellick G, Boyle R. Psychiatric disorders in idiopathic-isolated focal dystonia. J Neurol 2014; 261:668-74. [DOI: 10.1007/s00415-014-7244-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/05/2014] [Accepted: 01/07/2014] [Indexed: 11/28/2022]
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Dias FMV, Kummer A, Doyle FCP, Harsányi E, Cardoso F, Fontenelle LF, Teixeira AL. Psychiatric disorders in primary focal dystonia and in Parkinson's disease. Neuropsychiatr Dis Treat 2011; 7:111-6. [PMID: 21552313 PMCID: PMC3083984 DOI: 10.2147/ndt.s17507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Primary focal dystonia and Parkinson's disease are movement disorders that have contrasting motor phenotypes. The aim of this study was to compare the frequency and the severity of psychiatric disorders in primary focal dystonia and Parkinson's disease. METHODS Two groups of 30 patients matched by gender and age underwent a neurological and psychiatric assessment. RESULTS Parkinson's disease patients were diagnosed with higher rates of major depression (P = 0.02) and generalized anxiety disorder (P = 0.02), and greater severity of depressive symptoms (P = 0.04), while patients with primary focal dystonia exhibited increased severity of obsessive-compulsive symptoms (P = 0.02). DISCUSSION The difference in pathophysiology of primary focal dystonia and Parkinson's disease may explain the different psychiatric profiles of these two diseases. The increased frequency of affective symptoms in Parkinson's disease may be related to the fact that Parkinson's disease is a neurodegenerative disease marked by the loss of monoaminergic neurons which does not happen in primary focal dystonia. CONCLUSION The psychiatric profile differs in movement disorders with distinct neurobiological bases.
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Affiliation(s)
| | | | - Flávia CP Doyle
- Movement Disorders Clinic, Neurology Unit, University Hospital, Federal University of Minas Gerais, Belo Horizonte
| | | | - Francisco Cardoso
- Movement Disorders Clinic, Neurology Unit, University Hospital, Federal University of Minas Gerais, Belo Horizonte
| | - Leonardo F Fontenelle
- Department of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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