Cervical dystonia: non-motor aspects

Cervical dystonia (CD) is manifested by violent, often painful movements of the neck muscles with the abnormal head and/or neck postures being formed. Disease progression leads to disability of patients. The clinical picture of the disease is characterized by a concurrence of motor and non-motor disorders.Objective: to analyze the features of non-motor manifestations (pain, asthenia, anxiety, depression, sleep disorders) and quality of life (QOL) in patients with CD.Patients and methods. A total of110 patients (31 men and 89 women) aged 27—82years (mean age, 54.4±12.4 years) with CD (a study group) were examined. A control group consisted of 50 patients (16 men and 34 women) aged 25—82 years (mean age, 51.7±14.8 years) with cervical dorsalgia. Clinical, neurological, and neuropsychological examinations were made according to validated questionnaires. The investigators assessed pain using a visual analogue scale, anxiety and depressive disorders by the Hospital Anxiety and Depression Scale (HADS), asthenia by the Multidimensional Fatigue Inventory (MFI-20) and the scale of asthenic state (SAS), night sleep quality by the Pittsburg Sleep Quality Index (PSQI), and quality of life by the 36-Item Short Form Survey (SF-36).Results and discussion. The patients with CD showed a high incidence ofnon-motor disturbances: pain (98%), asthenia (90%), nocturnal sleep disorders (80%), anxiety (53%), and depression (48%). Non-motor symptoms were statistically significantly more obvious in the patients with CD than in those with cervical dorsalgia. The QOL indicators in CD were statistically significantly reduced in all physical and psychological parameters.Conclusion. Non-motor manifestations occupy an important place in the clinical picture of CD, substantially reducing the physical and psychological aspects of QOL in the patients