Advertisement

Neuroscience and Behavioral Physiology

, Volume 49, Issue 2, pp 271–274 | Cite as

Efficacy of Botulinum Therapy in Correcting the Level of Pain Syndrome and Quality of Life in Patients with Cervical Dystonia

  • Yu. V. KarakulovaEmail author
  • N. V. Loginova
Article
  • 2 Downloads

Objectives. To assess the severity of pain syndrome, emotional status, and quantitative levels of humoral serotonin in patients with cervical dystonia (CD) before and after botulinum therapy. Materials and methods. A simple open comparative study of the clinical characteristics of hyperkinesia, pain, and emotional status, quality of life, and serum and platelet serotonin levels was conducted in 48 patients with cervical dystonia at age 37–53 years before and one month after botulinum therapy with botulinum toxin A (Dysport) at doses of 500–1000 U. The control group consisted of 15 healthy subjects. Results. All patients presented with complaints of involuntary movements and neck pain. The overall indicator on the dystonic movements scale among the patients was 16.7 ± 7.7 points and the score on the TWSTRS scale was 46.48 ± 6.2 points; the mean visual analog pain score was 6.4 ± 1.08 points. The levels of depression and anxiety on the Hamilton scale were significantly greater in the patients group than in the controls. The levels of reactive and trait anxiety on the Spielberger–Hanin test in patients with CD were significantly (p < 0.005) greater than those in the healthy group. Correlation analysis identified a direct relationship between pain intensity on the TWSTRS scale and the level of anxiety on the Hamilton scale and the total points score for dystonic movements. Serum and platelet serotonin levels were significantly lower than in controls. After botulinum therapy, patients showed significant reductions in pain, anxiety, and depression, while platelet serotonin increased. Conclusions. Botulinum therapy with Dysport decreased the levels of pain and depression in patients with CD, improved quality of life, and stimulated the serotoninergic system.

Keywords

botulinum therapy Dysport serotonin cervical dystonia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    V. L. Golubev, “Clinical polymorphism and the treatment of muscle dystonia,” Zh. Nevrol. Psikhiat., 91, No. 3, 30–34 (1991).Google Scholar
  2. 2.
    S. L. Timerbaeva, Focal and Segmental Forms of Primary Dystonia: Clinical, Pathophysiological, and Molecular-Genetic Aspects: Dissertation for Doctorate in Medical Sciences, Moscow (2012), http://medical-diss.com/medicina/fokalnye-i-segmentarnye-formy-pervichnoy-distonii#ixzz4gP6kHFOd, acc. May 7, 2017.
  3. 3.
    V. N. Shtok, I. A. Ivanova-Smolenskaya, and O. S. Levin (eds.), Extrapyramidal Disorders: Guidelines for Diagnosis and Treatment, MEDpress-inform, Moscow (2002), http://parkinsonizm.ru/?page=91, acc. May 7, 2017.
  4. 4.
    V. L. Golubev, A. Yu. Makarov, O. R. Orlova, et al., “Clinical and electromyography characteristics of spastic torticollis,” Zh. Nevrol. Psikhiat., 95, No. 4, 40–42 (1995).Google Scholar
  5. 5.
    A. Albanese, F. Asmus, K. P. Bhatia, et al., “EFNS guidelines on diagnosis and treatment of primary dystonias,” Eur. J. Neurol., 18, No. 1, 5–18 (2011),  https://doi.org/10.1111/j.1468-1331.2010.03042.CrossRefPubMedGoogle Scholar
  6. 6.
    J. K. S. Tsui, “Cervical dystonia,” Handbook of Dystonia, J. K. S. Tsui and D. B. Calne (eds.), Marcel Dekker, New York (1995).Google Scholar
  7. 7.
    O. R. Orlova and H. N. Yakhno, The Use of Botox (Botulinum toxin type A) in Clinical Practice: a Guide for Physicians, The Catalog, Moscow (2000).Google Scholar
  8. 8.
    D. Tarsy and D. K. Simon, “Dystonia,” N. Engl. J. Med., 355, No. 8, 818–829 (2006), https://doi.org/ https://doi.org/10.1056/NEJMc062570.
  9. 9.
    Y. Ben-Shlomo, L. Camfield, and T. Warner, “What are the determinants of quality of life in people with cervical dystonia?” J Neurol. Neurosurg. Psychiatry, 72, No. 5, 608–614 (2002), https://doi.org/ https://doi.org/10.1136/jnnp.72.5.608.
  10. 10.
    I. A. Ivanova-Smolenskaya, E. D. Markova, and S. N. Illarioshkin, “Monogenic inheritance of nervous system disease,” in: Inherited Diseases of the Nervous System, Yu. E. Vel’tishchev and P. A. Temin (eds.). Meditsina, Moscow (1998).Google Scholar
  11. 11.
    T. Etgen, M. Mühlau, C. Gaser, and D. Sander, “Bilateral grey-matter increase in the putamen in primary blepharospasm,” J Neurol. Neurosurg. Psychiatry, 77, No. 9, 1017–1020 (2006), https://doi.org/ https://doi.org/10.1136/jnnp.2005.087148.
  12. 12.
    D. Martino, A. Di Giorgio, and E. D’Ambrosio, et al., “Cortical gray matter changes in primary blepharospasm: A voxel-based morphometry study,” Mov. Disord., 26, No. 10, 1907–1912 (2011),  https://doi.org/10.1002/mds.23724.CrossRefPubMedGoogle Scholar
  13. 13.
    O. N. Shcherskaya, Spastic Torticollis (clinical pathogenetic and social aspects): Dissertation for Master’s Degree in Medical Sciences, Moscow (1996), http://medical-diss.com/medicina/spasticheskayakrivosheya, acc. May 7, 2017.
  14. 14.
    O. R. Orlova, S. L. Timerbaeva, S. E. Khat’kova, et al., “Focal dystonias and their treatment with Dysport (botulinum toxin type A),” Zh. Nevrol. Psikhiat., 112, No. 5, 81–89 (2012).Google Scholar
  15. 15.
    M. Jahanshahi, “Factors that ameliorate or aggravate spasmodic torticollis,” J Neurol. Neurosurg. Psychiatry, 68, No. 2, 227–229 (2000),  https://doi.org/10.1136/jnnp.68.2.227.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Yu. V. Karakulova, “The pathogenetic mechanisms of tension headache,” Zh. Nevrol. Psikhiat., 106, No. 7, 52–56 (2006).Google Scholar
  17. 17.
    J. Jancovic, S. Leder, and D. Warner, “Cervical dystonia: Clinical findings and associated movement disorders,” Neurology, 41, 1088–1091 (1991).CrossRefGoogle Scholar
  18. 18.
    Z. A. Zalyalova and D. M. Abdulgalimova, “Pain syndrome before and after the use of Dysport in patients with spastic torticollis,” Zh. Nevrol. Psikhiat., 110, No. 11, 62–65 (2010).Google Scholar
  19. 19.
    M. Hallett, R. Benecke, A. Blitzer, and C. L. Comella, “Treatment of focal dystonias with botulinum neurotoxin,” Toxicon, 54, No. 5, 628–633 (2009),  https://doi.org/10.1016/j.toxicon.2008.12.008.CrossRefPubMedGoogle Scholar
  20. 20.
    A. Berardelli, J. C. Rothwell, and M. Hallett, “The pathophysiology of primary dystonia,” Brain, 121, 1195–1212 (1998), https://www.ncbi.nlm.nih.gov/pubmed/9679773, acc. May 7, 2017.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Vagner Perm State Medical UniversityRussian Ministry of HealthPermRussia

Personalised recommendations