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Kako T, Nokura K, Kaneko H, Izawa H. Subjective assessment of effectiveness, quality of life, and psychological status of patients receiving botulinum toxin therapy for hemifacial spasm, blepharospasm, or cervical dystonia. FUJITA MEDICAL JOURNAL 2022; 7:12-17. [PMID: 35111538 PMCID: PMC8749487 DOI: 10.20407/fmj.2019-027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/09/2020] [Indexed: 11/17/2022]
Abstract
Objectives:
Evaluations of subjective effectiveness, quality of life (QOL), and mental status of
patients receiving treatment with botulinum toxin (BTX) for hemifacial spasm (FS),
blepharospasm (BS), and cervical dystonia (CD) were conducted using a self-administered
questionnaire.
Methods:
Eighty-eight patients who received BTX treatment in the stable stage were
analyzed. A numerical rating scale was used to assess treatment effectiveness, home QOL,
and social QOL. Anxiety and depression were examined using the hospital anxiety and
depression scale.
Results:
In men, the treatment effectiveness was 2.1±1.0 for FS patients,
2.8±0.5 for BS patients, and 4.0±2.0 for CD patients, which indicates that
FS was more effectively treated than CD. QOL scores were higher and anxiety and
depression scores were lower in FS patients than BS and CD patients. Overall, social QOL
scores were lower than home QOL. A high prevalence ratio of depression was found in BS
and CD patients.
Conclusions:
CD responded less effectively to BTX compared with FS and BS. Additionally,
FS and BS patients exhibited similar treatment effects. All of these disorders affect
the patient’s appearance, which can reduce self-esteem and social QOL and potentially
cause anxiety and depression. BS and CD patients exhibited a higher prevalence of
depression than FS patients, which indicates a relationship with the underlying
mechanisms of dystonia. Asking patients about subjective effectiveness, QOL, and
psychiatric status can help staff respond to patient issues.
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Affiliation(s)
- Tetsuharu Kako
- Department of Neurology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Kazuya Nokura
- Department of Neurology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Hiroshi Kaneko
- Division of Psychosomatic Internal Medicine, Hoshigaoka Maternity Hospital, Nagoya, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
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Lane V, Lane M, Sturrock A, Rickards H. Understanding Psychiatric Disorders in Idiopathic and Inherited (Monogenic) Forms of Isolated and Combined Dystonia: A Systematic Review. J Neuropsychiatry Clin Neurosci 2021; 33:295-306. [PMID: 34280321 DOI: 10.1176/appi.neuropsych.20110293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The relationship between idiopathic and inherited (monogenic) forms of isolated and combined dystonia and psychiatric disorders remains unclear. In the present review, the authors aimed to provide increased clarity on this association through a systematic review of all controlled quantitative studies using a structured or semi-structured psychiatric interview to diagnose psychiatric disorders in individuals with these conditions. METHODS Three databases were searched to identify 20 eligible studies, with a total of 1,275 participants fulfilling inclusion criteria. Eligible articles were quality appraised and divided into four sections (idiopathic forms of dystonia [N=11], early-onset torsion dystonia [N=2], gene mutation positive myoclonus dystonia; DYT-SGCE [N=6], and rapid-onset dystonia-parkinsonism [N=1]). RESULTS For each study, results were grouped into subcategories (overall psychiatric comorbidity, anxiety disorders, mood disorders, substance misuse, and other [personality disorder and cognitive impairment]). For idiopathic dystonia, higher rates of psychiatric comorbidity, including mood and anxiety disorders, were noted when cases were compared with both healthy control subjects and control groups with a medical comorbidity. However, for major depressive disorder and obsessive-compulsive disorder (OCD) specifically, no differences were seen between groups. Study subjects with DYT-SGCE appeared to be at higher risk of psychiatric comorbidity, major depressive disorder, OCD, and alcohol dependence than control populations. CONCLUSIONS Overall, the prevalence of psychiatric comorbidity appears to be increased in individuals with idiopathic and inherited (monogenic) forms of isolated and combined dystonia compared with control subjects. This finding is not consistent for all comparisons, and further research is required to understand the nature of these associations and the underlying causative etiologies.
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Affiliation(s)
- Victoria Lane
- Neuropsychiatric Department, Barberry National Centre for Mental Health, Birmingham, United Kingdom
| | - Mark Lane
- Neuropsychiatric Department, Barberry National Centre for Mental Health, Birmingham, United Kingdom
| | - Aaron Sturrock
- Neuropsychiatric Department, Barberry National Centre for Mental Health, Birmingham, United Kingdom
| | - Hugh Rickards
- Neuropsychiatric Department, Barberry National Centre for Mental Health, Birmingham, United Kingdom
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3
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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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5
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Yadav R, Ray S, Pal P. Nonmotor symptoms and sleep disturbances in patients with blepharospasm. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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The long-term effects of microvascular decompression on social phobia and health-related quality of life in patients with hemifacial spasm: a 3-year prospective study. Acta Neurochir (Wien) 2019; 161:2035-2042. [PMID: 31368052 DOI: 10.1007/s00701-019-04023-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although not a life-threatening condition, hemifacial spasm (HFS) frequently leads to social phobia because it causes significant facial disfigurement and consequently reduces health-related quality of life (HRQoL). The purpose of the current study was to examine the long-term effects of MVD on psychological aspects and HRQoL in HFS patients with social anxiety over a 36-month follow-up. METHODS Thirty patients with HFS who underwent MVD from January 2015 to May 2015 were included in this prospective study. Clinical data, including standardized measures of general anxiety and depression (Hospital Anxiety Depression Scale (HADS)), social anxiety (Liebowitz Social Anxiety Scale (LSAS)), and the severity of HFS, were collected postoperatively, and 6 months and 36 months after MVD. Likewise, data on HRQoL were collected at baseline, and 6 months and 36 months after MVD using the Korean version of the Short Form 36 (SF-36). RESULTS Twenty-two patients who completed the 36-month follow-up were classified into social phobia group and non-social phobia group based on the LSAS total scores of 60. Repeated measures analysis of variance demonstrated significant differences between the two groups over time for the total LSAS score (p < 0.001), anxiety subscale score of the HADS (p = 0.002), and the Mental Component Summary (MCS) (p = 0.046) of the SF-36. A comparison of these two groups in terms of differences observed in their scales at 6 months after MVD has shown that the improvements of the social phobia group in HADS anxiety subscale (p = 0.010), LSAS total score (p = 0.008), and MCS (p = 0.040) were significantly more improved than the those of non-social phobia group. And at 36 months after surgery, the improvement of the scales mentioned above was maintained, and additionally Vitality (p = 0.040) and Mental Health (p = 0.040) dimensions showed a statistically significant improvement. CONCLUSIONS The improvements previously observed in psychological aspects and HRQoL over a short-term follow-up after MVD in HFS patients with social phobia were maintained for at least 36 months after MVD.
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Yuksel B, Genc F, Yaman A, Goksu EO, Ak PD, Gomceli YB. Evaluation of stigmatization in hemifacial spasm and quality of life before and after botulinum toxin treatment. Acta Neurol Belg 2019; 119:55-60. [PMID: 30178181 DOI: 10.1007/s13760-018-1018-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 08/31/2018] [Indexed: 01/15/2023]
Abstract
Hemifacial spasm (HFS) is a chronic disease that is characterized by involuntary tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. Botulinum toxin (BTX) is the most effective medical treatment of this condition. The aim of our study was to evaluate stigma among patients diagnosed with HFS and to search quality of life and depression before and after BTX injection. Seven self-rating items (HFS-7) and seven questions related to stigmatization were administered to HFS patients. Participants also answered SF-36 health outcome measure and Beck depression inventory before and 4 weeks after the routine BTX injection. The severity of HFS was graded based on a five-point scale. Descriptive statistics and paired t test were applied. The level of significance was set at α = 0.05. Fourty HFS patients were prospectively included. Twenty-one (%52.5) were female and nineteen were male (47.5%) with a mean age of 57.1 (SD = 12.13; min-max = 27-78). 60% (n: 24) of patients were feeling themselves different from people without HFS. Beck depression inventory scores improved after BTX injection significantly (p < 0.05). All domains of SF-36 showed positive improvement after BTX injections. The improvement in general health perception, physical functioning, and vitality was statistically significant (p < 0.05). Although more than half of the patients felt themselves different from people without HFS, treatment of HFS with BTX significantly improved mental health and physical health, and depressive symptoms of the patients.
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Affiliation(s)
- Burcu Yuksel
- Neurology Department, Antalya Training and Research Hospital, Muratpasa, 07050, Antalya, Turkey.
| | - Fatma Genc
- Neurology Department, Antalya Training and Research Hospital, Muratpasa, 07050, Antalya, Turkey
| | - Aylin Yaman
- Neurology Department, Antalya Training and Research Hospital, Muratpasa, 07050, Antalya, Turkey
| | - Eylem Ozaydin Goksu
- Neurology Department, Antalya Training and Research Hospital, Muratpasa, 07050, Antalya, Turkey
| | - Pelin Dogan Ak
- Neurology Department, Fatih Sultan Mehmet Training and Research Hospital, Kadıkoy, 34752, Istanbul, Turkey
| | - Yasemin Bicer Gomceli
- Neurology Department, Antalya Training and Research Hospital, Muratpasa, 07050, Antalya, Turkey
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8
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Cheng J, Lei D, Hui X, Zhang H. Improvement of Quality of Life in Patients with Hemifacial Spasm After Microvascular Decompression: A Prospective Study. World Neurosurg 2017; 107:549-553. [DOI: 10.1016/j.wneu.2017.08.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
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9
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Berman BD, Junker J, Shelton E, Sillau SH, Jinnah HA, Perlmutter JS, Espay AJ, Jankovic J, Vidailhet M, Bonnet C, Ondo W, Malaty IA, Rodríguez R, McDonald WM, Marsh L, Zurowski M, Bäumer T, Brüggemann N. Psychiatric associations of adult-onset focal dystonia phenotypes. J Neurol Neurosurg Psychiatry 2017; 88:595-602. [PMID: 28438790 PMCID: PMC5659143 DOI: 10.1136/jnnp-2016-315461] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/09/2017] [Accepted: 03/19/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Depression and anxiety frequently accompany the motor manifestations of isolated adult-onset focal dystonias. Whether the body region affected when this type of dystonia first presents is associated with the severity of these neuropsychiatric symptoms is unknown. OBJECTIVES The aim of this study was to determine whether depression, anxiety and social anxiety vary by dystonia onset site and evaluate whether pain and dystonia severity account for any differences. METHODS Patients with isolated focal dystonia evaluated within 5 years from symptom onset, enrolled in the Natural History Project of the Dystonia Coalition, were included in the analysis. Individual onset sites were grouped into five body regions: cervical, laryngeal, limb, lower cranial and upper cranial. Neuropsychiatric symptoms were rated using the Beck Depression Inventory, Hospital Anxiety and Depression Scale and Liebowitz Social Anxiety Scale. Pain was estimated using the 36-Item Short Form Survey. RESULTS Four hundred and seventy-eight subjects met our inclusion criteria. High levels of depression, anxiety and social anxiety occurred in all groups; however, the severity of anxiety and social anxiety symptoms varied by onset site group. The most pronounced differences were higher anxiety in cervical and laryngeal, lower anxiety in upper cranial and higher social anxiety in laryngeal. Increases in pain were associated with worse neuropsychiatric symptom scores within all groups. Higher anxiety and social anxiety in laryngeal and lower anxiety in upper cranial persisted after correcting for pain and dystonia severity. CONCLUSION Anxiety and social anxiety severity vary by onset site of focal dystonia, and this variation is not explained by differences in pain and dystonia severity.
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Affiliation(s)
- Brian D Berman
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Neurology Section, VA Eastern Colorado Health Care System, Denver, Colorado, USA
| | - Johanna Junker
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany.,Department of Neurology, University of Luebeck, Luebeck, Germany
| | - Erika Shelton
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stefan H Sillau
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - H A Jinnah
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Joel S Perlmutter
- Departments of Neurology, Radiology, Neuroscience, Physical Therapy and Occupational Therapy, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Alberto J Espay
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Joseph Jankovic
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - Marie Vidailhet
- Département de neurologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hopitaux de Paris, Paris, France.,UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, UM 75, ICM, F-75013, Sorbonne Universites, Paris, France
| | - Cecilia Bonnet
- Département de neurologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hopitaux de Paris, Paris, France.,UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, UM 75, ICM, F-75013, Sorbonne Universites, Paris, France
| | - William Ondo
- Department of Neurology, Houston Methodist, Houston, Texas, USA
| | - Irene A Malaty
- Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
| | - Ramón Rodríguez
- Department of Internal Medicine, University of Central Florida, Orlando, Florida, USA
| | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Laura Marsh
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA
| | - Mateusz Zurowski
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Tobias Bäumer
- Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany.,Department of Neurology, University of Luebeck, Luebeck, Germany
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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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Kim YG, Jung NY, Kim M, Chang WS, Jung HH, Chang JW. Benefits of microvascular decompression on social anxiety disorder and health-related quality of life in patients with hemifacial spasm. Acta Neurochir (Wien) 2016; 158:1397-404. [PMID: 27155866 DOI: 10.1007/s00701-016-2822-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/21/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hemifacial spasm (HFS), an involuntary movement disorder characterized by unilateral spasms of the muscles innervated by the facial nerve, is likely to cause social anxiety disorder due to its significant facial disfigurement and may have a significant influence on a patient's health-related quality of life (HRQoL). The goal of this study was to investigate the influence of microvascular decompression (MVD) on the severity of social anxiety symptoms and HRQoL in patients with HFS. METHODS Patients who underwent MVD from January to May 2015 were included in this study. Demographic data were collected before surgery. Clinical data, including the standardized measures of anxiety and depression (Hospital Anxiety Depression Scale, HADS), social anxiety (Liebowitz Social Anxiety Scale, LSAS), and the severity of HFS were assessed before surgery and 6 months after surgery. HRQoL data were also collected before surgery and 6 months after surgery using the Korean version of the short form 36 (SF-36). RESULTS Six patients (21.4 %) scored 60 or greater on the preoperative LSAS and were considered to have generalized social anxiety disorder (high-LSAS group). The duration of symptom was significantly higher in the high-LSAS group than in the low-LSAS group (7.8 ± 2.2 vs. 4.1 ± 2.6; p = 0.011). The high-LSAS group was more likely to have psychological comorbidities and had a more impaired quality of life than the low-LSAS group at preoperative evaluation. Six months after MVD, a significant improvement, compared to preoperative scores, was observed for the total LSAS score (p = 0.007) and anxiety subscale score of HADS (p = 0.012) in the high-LSAS group. Other significant improvements were also observed in role-emotional (p = 0.039) and mental component summary (p = 0.024) of the SF-36 in the high-LSAS group compared to the low-LSAS group. CONCLUSIONS This study shows that HFS patients seem to gain benefits from MVD not only for their facial disfigurement but also for social anxiety symptoms that may be associated with mental health improvements in their quality of life.
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Affiliation(s)
- Young Goo Kim
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Na Young Jung
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - MinSoo Kim
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Won Seok Chang
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hyun Ho Jung
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Jin Woo Chang
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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12
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Fontenelle LF, Pacheco PG, Nascimento PM, de Freitas AR, Rosso AL, Teixeira AL, Lauterbach EC. Obsessive-compulsive symptoms among patients with blepharospasm and hemifacial spasm. Gen Hosp Psychiatry 2011; 33:476-81. [PMID: 21762995 DOI: 10.1016/j.genhosppsych.2011.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 05/23/2011] [Accepted: 05/24/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare the prevalence and the severity of different obsessive-compulsive disorder (OCD) symptoms reported by patients with blepharospasm (BSP) with those reported by patients with hemifacial spasm (HFS). We hypothesized that, since patients with BSP present a dysfunctional striato-thalamo-cortical circuitry, they would exhibit higher prevalence and/or greater severity of OCD symptoms than patients with HFS, a condition that results from peripheral irritation of the facial nerve. METHODS Twenty-two patients with BSP and 31 patients with HFS were systematically evaluated by means of a sociodemographic and clinical questionnaire, the Mini International Neuropsychiatric Interview, the Obsessive-Compulsive Inventory-Revised, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Mini Mental State Examination (MMSE). Diagnostic groups were compared using the Mann-Whitney U test for continuous variables and the Pearson's goodness-of-fit χ(2) test for categorical ones; Fisher's Exact Test was employed when indicated. Correlations between continuous variables were evaluated by means of Spearman coefficients. RESULTS Patients with BSP and HFS were not significantly different in terms of sociodemographic characteristics and most neuropsychiatric features. Nevertheless, while checking was associated with shorter duration of BSP (Spearman's rho=-0.54; P=.01), hoarding correlated with a longer duration of HFS (Spearman's rho=0.40; P=.04). Length of abnormal movements did not correlate with the BDI, BAI and MMSE scores. CONCLUSIONS The finding that the severity of different OCD symptoms did not differ between the BSP and HFS groups suggests that BSP may not interfere significantly with behavioral components of the striato-thalamo-cortical circuitry. However, the fact that OCD symptoms were found to follow different courses in distinct diagnostic groups deserves further study.
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Affiliation(s)
- Leonardo F Fontenelle
- Programa de Ansiedade e Depressão, Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.
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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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14
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Malhi GS. In the blink of an eye …. Acta Neuropsychiatr 2010; 22:211. [PMID: 26952829 DOI: 10.1111/j.1601-5215.2010.00490.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gin S Malhi
- 1CADE Clinic, Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia
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