The Impact Of Cognitive, Mood And Sleep Disorders And Pain On QOL Of Patients With Dystonia

Objective:The present study was aimed at discussing cognitive, mood and sleep disorders and pain of the first diagnosticated patients with dystonia, and analsying their impact on patients’ quality of life. The purpose was to provide theory basis for prevention and treatment and to improve the patients’ quality of life.Methods:Patients group consisted of20first diagnosticated patients with dystonia at the First Affiliated Hospital of Kunming Medical University Department of Nrurology clinic from august2012to February2013(6patients with Meige syndrome, and14patients with spasmodic torticollis). Control group consisted of35healthy subjects, matched with patient group by age, sex, education and marital status. We used the Rey complex figure test (CFT), the Rey auditory verbal learning test (AVLT), the trail making test-A (TMT-A), the Stroop color-word test (CWT), the verbal fluency test (VFT), the symbol digit modalities test (SDMT), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA), the Pittsburgh sleep quality index (PSQI), the Numerical rating scale (NRS) and the MOS36-item short from health survey (SF-36) to evaluate all subjects. Then we used SPSS17.0software to analyze variables statistically.Results:Compared with the control group, the patient’s QOL was worse (P<0.05). The CFT, TMT-A, CWT and SDMT tests scores did not decrease (P>0.05), and the. AVLT and VFT tests (recognition memory and verbal fluency) scores were lower, but there was no correlation between results of AVLT and VFT tests and results of patients’QOL. Among20patients with dystonia, the incidence of anxiety was35%(possible state of anxiety accounted for20%, certainly anxiety accounted for15%), the incidence of depression was45%(possible state of depression accounted for30%, certainly depression accounted for10%), and anxiety associated with depression was30%. Anxiety and depression affected various aspects of QOL. Sleep latency was longer than controls,, and there was a correlation between sleep latency and several aspects of QOL (physical functioning, role-physical, role-emotional, bodily pain)(P <0.05). The NRS survey found that the incidence of painin patients with dystonia was65%, impacting every aspect of QOL (P<0.05).Conclusions:Cognitive dysfunction is common in patients with dystonia, mainly including memory and executive function disorders, but visuospatial function, attentional function or information processing speed is not impaired. The incidence of depression and anxiety, sleep disorder, and pain in patients with dystonia is very high, and they are risk factors for a worse QOL.