Cognitive impairment and mental disorders in patients with focal muscular dystonia
Abstract
Non-motor manifestations in focal muscular dystonia (FMD) have been little studied.
Objective: to analyze the characteristics of cognitive impairment (CI) and mental disorders (MDs) in FMD.
Patients and methods. Fifteen patients (7 men and 8 women) aged 25 to 80 years (mean age, 59.8±14.7 years) with FMD were examined. Cervical dystonia and blepharospasm were noted in 10 (66.7%) and 5 (33.3%) patients, respectively. A control group consisted of 15 healthy individuals (7 men and 8 women) (mean age, 58.2±14.9 years). Neurological and standardized psychiatric examinations and neuropsychological tests were performed; the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory were used.
Results and discussion. Patients with FMD were found to have moderate CI as impaired control functions. Depression was diagnosed in 9 (60%) patients; it corresponded to the pattern of protracted psychogenically provoked conditions in most cases (n = 8). Six (40%) patients with FMD had anxiety and somatic disorders. The pathophysiology of non-motor manifestations of FMD is likely to depend on many factors, including the relationship between different clinical factors and basal ganglia dysfunction. The data on the association between emotional disorders and CI in FMD are contradictory. MDs can seem to be as an additional factor that aggravates the manifestations of dystonia.
Conclusion. In patients with FMD, moderate CI can be due to emotional disorders that aggravate the manifestations of the disease. The diagnosis and correction of emotional disorders are promising in the management of patients with FMD.
About the Authors
V. A. TolmachevaRussian Federation
11, Rossolimo St., Build. 1, Moscow 119021
D. A. Grishina
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
D. V. Romanov
Russian Federation
6, Bolshaya Pirogovskaya St., Build. 1, Moscow 119435;
34, Kashirskoe Shosse, Moscow 115522
References
1. Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013 Jun 15;28(7):863-73. doi: 10.1002/mds.25475. Epub 2013 May 6.
2. Steeves TD, Day L, Dykeman J, Jette N, Pringsheim T. The prevalence of primary dystonia: A Mov Disord. 2012 Dec;27(14):1789-96. doi: 10.1002/mds.25244. Epub 2012 Oct 31.
3. Soeder A, Kluger BM, Okun MS, et al. Mood and energy determinants of quality of life in dystonia. J Neurol. 2009 Jun;256(6):996-1001. doi: 10.1007/s00415-009-5060-3. Epub 2009 Mar 10.
4. Tolmacheva VA, Nodel MR, Saloukhina NI. Non-motor disorders in cervical dystonia. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):135-40. (In Russ.) doi: 10.14412/2074-2711-2018-3-135-140
5. Foley JA, Vinke RS, Limousin P, Cipolotti L. Relationship of Cognitive Function to Motor Symptoms and Mood Disorders in Patients with Isolated Dystonia. Cogn Behav Neurol. 2017 Mar; 30(1):16-22. doi: 10.1097/WNN.0000000000000117.
6. Jahanshahi M, Rowe J, Fuller R. Cognitive executive function in dystonia. Mov Disord. 2003 Dec;18(12):1470-81.
7. Van Tricht MJ, Dreissen YE, Cath D, et al. Cognition and psychopathology in myoclonusdystonia. J Neurol Neurosurg Psychiatry. 2012 Aug;83(8):814-20. doi: 10.1136/jnnp-2011-301386. Epub 2012 May 23.
8. Balas M, Peretz C, Badarny S, et al. Neuropsychological profile of DYT1 dystonia. Mov Disord. 2006 Dec;21(12):2073-7.
9. Romano R, Bertolino A, Gigante A, et al. Impaired cognitive functions in adult-onset primary cranial cervical dystonia. Parkinsonism Relat Disord. 2014 Feb;20(2):162-5. doi: 10.1016/j.parkreldis.2013.10.008. Epub 2013 Oct 17.
10. Aleman GG, de Erausquin GA, Micheli F. Cognitive disturbances in primary blepharospasm. Mov Disord. 2009 Oct 30;24(14):2112-20. doi: 10.1002/mds.22736.
11. Taylor AE, Lang AE, Saint-Cyr JA, et al. Cognitive processes in idiopathic dystonia treated with high-dose anticholinergic therapy: implications for treatment strategies. Clin Neuropharmacol. 1991 Feb;14(1):62-77.
12. Ostrem JL, Racine CA, Glass GA, et al. Subthalamic nucleus deep brain stimulation in primary cervical dystonia. Neurology. 2011 Mar 8;76(10):870-8. doi: 10.1212/WNL.0b013e31820f2e4f.
13. Conte A, Berardelli I, Ferrazzano G, et al. Non-motor symptoms in patients with adultonset focal dystonia: Sensory and psychiatric disturbances. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S111-4. doi: 10.1016/j.parkreldis.2015.09.001. Epub 2015 Sep 3. Review.
14. Gundel H, Wolf A, Xidara V, et al. High psychiatric comorbidity in spasmodic torticollis: a controlled study. J Nerv Ment Dis. 2003 Jul; 191(7):465-73.
15. Lewis L, Butler A, Jahanshahi M. Depression in focal, segmental and generalized dystonia. J Neurol. 2008 Nov;255(11):1750-5. doi: 10.1007/s00415-008-0020-x. Epub 2008 Nov 13.
16. Fabbrini G, Berardelli I, Moretti G, et al. Psychiatric disorders in adult-onset focal dystonia: a case-control study. Mov Disord. 2010 Mar 15;25(4):459-65. doi: 10.1002/mds.22983.
17. Albanese A, Di Giovanni M, Lalli S. Dystonia: diagnosis and management. Eur J Neurol. 2019 Jan;26(1):5-17. doi: 10.1111/ene.13762. Epub 2018 Aug 18.
18. Zakharov VV, Voznesenskaya TG. Nervno-psikhicheskie narusheniya: diagnosticheskie testy [Neuropsychiatric disorders: diagnostic tests]. 2nd ed. Moscow: MEDpress-inform; 2013. 320 p.
19. Consky E, Basinski A, Belle L, Ranawaya R, Lang AE. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS): assessment of validity and inter-rater reliability [abstract]. Neurology 1990;40(suppl 1):445.
20. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57.
21. Smulevich AB. Psikhicheskie rasstroistva v klinicheskoi praktike [Mental disorders in clinical practice]. Moscow: MEDpress-inform; 2011.
22. Bugalho P, Corrеa B, Guimarаes J, Xavier M. Set-shifting and behavioral dysfunction in primary focal dystonia. Mov Disord. 2008 Jan 30; 23(2):200-6.
23. Jinnah HA, Neychev V, Hess EJ. The Anatomical Basis for Dystonia: The Motor Network Model. Tremor Other Hyperkinet Mov (N Y). 2017 Oct 23;7:506. doi: 10.7916/D8V69X3S.eCollection 2017.
24. Petersen RC, Touchon J. Consensus on mild cognitive impairment: EADC – ADCS. Research and Practice in Alzheimer's Disease. 2005;10:38-46.
25. Yang J, Shao N, Song W, et al. Nonmotor symptoms in primary adult-onset cervical dystonia and blepharospasm. Brain Behav. 2016 Dec 18;7(2):e00592. doi: 10.1002/brb3.592.eCollection 2017 Feb.
26. Yang J, Luo C, Song W, et al. Altered regional spontaneous neuronal activity in blepharospasm: a resting state fMRI study. J Neurol. 2013 Nov;260(11):2754-60. doi: 10.1007/s00415-013-7042-8. Epub 2013 Jul 31.
27. Zoons E, Booij J, Nederveen AJ, et al. Structural, functional and molecular imaging of the brain in primary focal dystonia – A review. Neuroimage. 2011 Jun 1;56(3):1011-20. doi: 10.1016/j.neuroimage.2011.02.045. Epub 2011 Feb 22.
28. Lencer R, Steinlechner S, Stahlberg J, et al. Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles. J Neurol Neurosurg Psychiatry. 2009 Oct;80(10):1176-9. doi: 10.1136/jnnp.2008.170191
29. Lehn A, Mellick G, Boyle R. Psychiatric disorders in idiopathic-isolated focal dystonia. J Neurol. 2014 Apr;261(4):668-74. doi: 10.1007/s00415-014-7244-8. Epub 2014 Jan 22.
30. Barahona-Correa B, Bugalho P, Guimaraes J, Xavier M. Obsessive- compulsive symptoms in primary focal dystonia: a controlled study. Mov Disord. 2011 Oct;26(12):2274-8. doi: 10.1002/mds.23906. Epub 2011 Aug 9.
31. Di Giuda D, Camardese G, Cocciolillo F, Fasano A. Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a 123I-FP-CIT SPECT study. Eur J Nucl Med Mol Imaging. 2012 Dec;39(12):1937-48. doi: 10.1007/s00259-012-2232-7. Epub 2012 Sep 14.
Review
For citations:
Tolmacheva V.A., Grishina D.A., Romanov D.V. Cognitive impairment and mental disorders in patients with focal muscular dystonia. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(4):51-56. (In Russ.) https://doi.org/10.14412/2074-2711-2019-4-51-56