title: Benefits of microvascular decompression on social anxiety disorder and health-related quality of life in patients with hemifacial spasm.
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: MinSoo
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Hyun Ho
authors.initials: HH
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, 205 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea. jchang@yuhs.ac.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005154:Facial Nerve / Q000601:surgery; D005260:Female; D019569:Hemifacial Spasm / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery; D008875:Middle Aged; D011788:Quality of Life
keywords: Health-related quality of life; Hemifacial spasm; Liebowitz Social Anxiety Scale; Microvascular decompression; Social anxiety disorder