title: Factors affecting the health-related quality of life of patients with cervical dystonia and the impact of botulinum toxin type A injections.
abstract: The purpose of this study was to analyze the health-related quality of life (HRQL) of patients with cervical dystonia (CD) and the impact of botulinum toxin A (BTX-A) therapy in these patients. The authors recruited 101 patients with CD, all previously treated with BTX-A. Both before and 4 weeks after injection of BTX-A the patients were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), a Visual Analogue Scale for pain (VAS: 0-100%), the Short Form 36 health survey questionnaire (SF-36), and the Montgomery-Asberg Depression Rating Scale (MADRS). A control group of 84 healthy volunteers was also evaluated. The patients? baseline SF-36 scores were worse in all the domains when compared with those of the controls. Depression was found in 47.5% of the patients. Improvements were noticed 4 weeks after the single BTX-A injections in all the SF-36 domains, and in the VAS, TWSTRS and MADRS scores. The TWSTRS results did not correlate with any of the SF-36 subscores. Stepwise backward regression analysis revealed depression as the main predictor of poor HRQL, as well as female sex, poor financial situation, and living alone. On contrary, longer treatment with BTX-A was associated with better scores. Cervical dystonia has a marked impact on HRQL and treatment with BTX-A injections has a beneficial effect, seen both in objective and in subjective measures. Depression in CD patients is a main predictor of worse HRQL.
authors.affiliation: Department of Neurological-Psychiatric Nursing, Medical University, Gdansk, Poland. jaroslawek@amg.gda.pl
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Slawek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Friedman
authors.forename: Anna
authors.initials: A
authors.lastname: Potulska
authors.forename: Pierre
authors.initials: P
authors.lastname: Krystkowiak
authors.forename: Claire
authors.initials: C
authors.lastname: Gervais
authors.forename: Marta
authors.initials: M
authors.lastname: Banach
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Ochudlo
authors.forename: Slawomir
authors.initials: S
authors.lastname: Budrewicz
authors.forename: Daniel
authors.initials: D
authors.lastname: Reclawowicz
authors.forename: Michal
authors.initials: M
authors.lastname: Rynkowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opala
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014103:Torticollis / Q000188:drug therapy* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A