Psychiatric associations of adult-onset focal dystonia phenotypes

• Type of Material: Article
• Authors: Brian D. Berman, University of Colorado; Johanna Junker, University of Lubeck; Erika Shelton, University of Colorado; Stefan H. Sillau, University of Colorado; Hyder Jinnah, Emory University; Joel S. Perlmutter, Washington University in Saint Louis; Alberto J. Espay, University of Cincinnati; Joseph Jankovic, Baylor College of Medicine; Marie Vidailhet, Hôpital Pitié-Salpêtrière; Cecilia Bonnet, Hôpital Pitié-Salpêtrière; William Ondo, Houston Methodist; Irene A. Malaty, University of Florida; Ramón Rodriguez, University of Central Florida; William McDonald, Emory University; Laura Marsh, Baylor College of Medicine; Mateusz Zurowski, University of Toronto; Tobias Baumer, Institute of Neurogenetics; Norbert Bruggemann, University of Lubeck
• Language: English
• Date: 2017-07-01
• Publisher: BMJ Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/jnnp-2016-315461
• Title of Journal or Parent Work: Journal of Neurology, Neurosurgery and Psychiatry
• ISSN: 0022-3050
• Volume: 88
• Issue: 7
• Start Page: 595
• End Page: 602
• Grant/Funding Information: This work was supported in part by grants to the Dystonia Coalition (U54NS065701/TR001456), a consortium of the Rare Diseases Clinical Research Network (RDCRN) that is supported by the Office of Rare Diseases Research (ORDR) at the National Center for Advancing Clinical and Translational Studies (NCATS) in collaboration with the National Institute for Neurological Diseases and Stroke (NINDS).; This study was supported by a grant from the National Institutes of Health (Dystonia Coalition U54 NS065701).
• Keywords: SOCIAL ANXIETY; Pain; CERVICAL DYSTONIA; Isolated focal dystonia; Depression; SPASMODIC DYSPHONIA; EMERGING CONCEPTS; Neurosciences & Neurology; Life Sciences & Biomedicine; Science & Technology; Surgery; DISORDERS; HOSPITAL ANXIETY; Clinical Neurology; NONMOTOR SYMPTOMS; GENERALIZED DYSTONIA; QUALITY-OF-LIFE; Anxiety; Psychiatry; DEPRESSION SCALE
• Research Categories: Biology, Genetics; Psychology, Behavioral; Biology, Neuroscience

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.