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Determinants and status of quality of life after long‐term botulinum toxin therapy for cervical dystonia

2007; Wiley; Volume: 14; Issue: 10 Linguagem: Inglês

10.1111/j.1468-1331.2007.01922.x

1468-1331

Inger Marie Skogseid, Ulrik Fredrik Malt, Jo Røislien, Emı́lia Kerty,

Neurological disorders and treatments

The aim of this study was to assess health‐related quality of life (HRQoL), using the Short Form Health Survey‐36 (SF‐36), in 70 cervical dystonia (CD) patients after long‐term botulinum toxin (BTX) treatment (median 5.5 years), and to identify factors determining reduced HRQoL. We used combined patient‐and physician‐based measures to assess both CD severity [Toronto Western Spasmodic Torticollis Rating Scale, (TWSTRS)] and effect of long‐term BTX treatment, and the Hospital Anxiety and Depression Scale (HAD) and General Health Questionnaire‐30 to assess psychological distress. Mean SF‐36 domain scores of the CD patients were reduced by <1 SD compared with age‐ and gender‐matched population samples. High TWSTRS total scores and high HAD‐depression (HAD‐D) scores were the main factors associated with reduced scores in the physical and mental SF‐36 domains, respectively. Patients evaluated to have a ‘good effect’ of long‐term BTX treatment ( n = 47), had significantly lower median TWSTRS total score, and a 3× lower frequency of high HAD‐D scores, than those evaluated to an ‘unsatisfactory effect’ ( n = 23). In conclusion, most CD patients enjoy a good HRQoL after long‐term BTX therapy. Reduced HRQoL was associated with more severe disease and/or depressive symptoms.