The Effect Of Botulinum Toxin Type A On Non Motor Symptoms And Quality Of Life In Adults With Spasmodic Torticollis

Purpose:Exploring the effects of botulinum toxin type A(BTX-A)on non motor symptoms and quality of life in spasmodic torticollis(ST),including pain,anxiety,depression,sleep,and cognitive function,and further exploring the relationship between changes in motor symptoms,non motor symptoms,and quality of life after BTX-A treatment.Research methods:From December 2021 to November 2022,Collected patients who were diagnosed as ST and were treated with BTX-A intramuscular injection at the Department of Neurology of the Second Affiliated Hospital of Nanchang University were selected.The scores of motor symptoms,non-motor symptoms and quality of life of the patients were evaluated with relevant scales before and 1 month and 3months after treatment,and analyzed the results.Result:1.A total of 46 patients with ST were included in this study.There were 24 females and 22 males.There were 25 patients with pain(54.35%),26 patients with anxiety(56.52%),27 patients with depression(58.70%),21 patients with sleep disorders(45.65%),17 patients with insomnia(36.96%),9 patients with daytime sleepiness(19.57%),and 10 patients with cognitive decline(21.74%).2.After 1 and 3 months of BTX-A treatment,the motor symptom scores(Tusi,TWSTRS severity)of ST patients significantly decreased compared to before treatment(p<0.05).The scores of pain,anxiety,and depression(TWSTRS pain,HAMA,HAMD)significantly decreased compared to before treatment(p<0.05).The scores of sleep quality,insomnia,daytime drowsiness,and cognitive impairment(PSQI,ISI,ESS,Mo CA)showed no significant changes compared to before treatment(p>0.05).In addition to the sleep score,the quality of life score(CDIP-58)was significantly improved compared to before treatment(p<0.05).3.In ST patients,there was no significant correlation between non motor symptom scores(TWSTRS pain,HAMA,HAMD,PSQI,ISI,ESS,Mo CA)and motor symptom scores(TWSTRS severity,Tusi)(p>0.05).There is no significant correlation between the improvement of pain,anxiety,and depression and the improvement of motor symptoms(p>0.05).4.In ST patients,motor symptom scores were positively correlated with head and neck symptoms,pain and discomfort,upper limb activity,walking,and psychosocial function quality of life scores(p<0.05);The TWSTRS pain score was positively correlated with head and neck symptoms,pain and discomfort,upper limb activity,walking,and emotional quality of life scores(p<0.05);The HAMA and HAMD scores were positively correlated with pain and discomfort,sleep,disturbance,emotion,and psychosocial function quality of life scores(p<0.05).The PSQI,ISI,and ESS scores were positively correlated with pain and discomfort,sleep,disturbance,emotion,and psychosocial function quality of life scores(p<0.05),The Mo CA score is negatively correlated with PD and A quality of life scores(p<0.05).The improvement of head and neck symptoms,upper limb activity,and walking quality of life scores is positively correlated with the improvement of motor symptom scores(p<0.05),while the improvement of pain and discomfort,disturbance,emotion,and psychosocial function quality of life scores is positively correlated with the improvement of pain,anxiety,and depression(p<0.05).Conclusion:1.The severity of non motor symptoms(pain,anxiety,depression,sleep disorders,cognitive impairment)in ST patients is not significantly correlated with the severity of motor symptoms.2.BTX-A treatment can improve the motor symptoms and some non motor symptoms(pain,anxiety,depression)of ST patients,but there is no significant improvement in sleep and cognitive function.There is no significant correlation between the improvement of pain,anxiety,and depression and the improvement of motor symptoms.3.BTX-A treatment can improve the quality of life of patients,among which the improvement of head and neck symptoms,upper limb activity,and walking quality of life may be related to the improvement of motor symptoms,and the improvement of pain and discomfort,annoyance,emotions,and psychosocial function quality of life may be related to the improvement of pain,anxiety,and depression.