The Frequency and Self-perceived Impact on Daily Life of Motor and Non-motor Symptoms in Cervical Dystonia

Background: Evidence suggests that non-motor symptoms (NMS) are the most important predictors of decreased health-related quality of life (HR-QoL) in patients with cervical dystonia (CD). In this study, we evaluate an NMS screening list and examine the influence of motor symptoms and NMS on HR-QoL.Methods: In 40 patients with CD, the frequency of NMS was evaluated using an extended NMS questionnaire. Furthermore, patients composed a list of their 5 most burdensome motor symptoms and NMS and scored the severity of predefined symptoms. HR-QoL was examined with the RAND 36-item Health Survey.Results: Of 40 patients, 38 experienced NMS (median number of NMS, 6.5; range, 0-13; maximum, 15). The self-perceived most burdensome symptoms were tremor/jerks, pain, sleep disturbances, daily-life limitations, and fatigue. Also, of the predefined symptom list, tremor and fatigue were identified as the most disturbing. Several domains of HR-QoL were significantly influenced by NMS, whereas motor symptoms had only a small influence on the physical functioning domain of HR-QoL.Conclusion: Our findings highlight the impact of NMS on HR-QoL and emphasize the importance of a standardized, validated NMS questionnaire for patients with dystonia. This would enable us to monitor the effect of treatment for motor symptoms and NMS on an individual basis and improve treatment options.