Abstract：
Anxiety is present in 30-40% of patients with cervical dystonia (CD). It has been ascribed to a direct effect of the state of motor symptoms on related pain, disability, and disfigurement. Accordingly, any reported benefit of botulinum toxin (BoNT) on anxiety is thought to be secondary to its effect on the same. We sought to evaluate the distinctive impact of botulinum toxin (BoNT) on anxiety in cervical dystonia (CD).
In this prospective observational study, 60 participants with idiopathic isolated CD were recruited from clinic. We assessed motor and anxiety burden using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) parts I-III and State-Trait Anxiety Inventory (STAI). Assessments were done at time of BoNT (baseline) and at 6 weeks post-injection.
STAI and motor severity TWSTRS scores poorly correlated at the baseline visit (rho = -0.30, p = 0.411). Both, motor TWSTRS (Mdifference = -1.46, p < 0.024) and STAI (Mdifference = -10.37, p = 0.007) improved from baseline to 6 weeks (peak effect). The change in motor TWSTRS poorly correlated with change in anxiety scores from baseline visit to 6 weeks (rho = -0.14, p > 0.999). Of these measures of anxiety, improvement in STAI-T had the largest effect size (rank biserial = 0.52).
BoNT improves both motor severity and anxiety in CD. Poor correlation between motor severity and anxiety at both the time of injection and during the time of peak effect, and improvement in trait anxiety suggests that BoNT has a direct beneficial effect on anxiety.
In this prospective observational study, 60 participants with idiopathic isolated CD were recruited from clinic. We assessed motor and anxiety burden using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) parts I-III and State-Trait Anxiety Inventory (STAI). Assessments were done at time of BoNT (baseline) and at 6 weeks post-injection.
STAI and motor severity TWSTRS scores poorly correlated at the baseline visit (rho = -0.30, p = 0.411). Both, motor TWSTRS (Mdifference = -1.46, p < 0.024) and STAI (Mdifference = -10.37, p = 0.007) improved from baseline to 6 weeks (peak effect). The change in motor TWSTRS poorly correlated with change in anxiety scores from baseline visit to 6 weeks (rho = -0.14, p > 0.999). Of these measures of anxiety, improvement in STAI-T had the largest effect size (rank biserial = 0.52).
BoNT improves both motor severity and anxiety in CD. Poor correlation between motor severity and anxiety at both the time of injection and during the time of peak effect, and improvement in trait anxiety suggests that BoNT has a direct beneficial effect on anxiety.
摘要：
背景：焦虑存在于30-40%的宫颈肌张力障碍（CD）患者中。它被归因于运动症状状态对相关疼痛的直接影响，残疾,和毁容。因此，任何报道的肉毒杆菌毒素(BoNT)对焦虑的益处被认为是其对焦虑的影响的次要因素。我们试图评估肉毒杆菌毒素（BoNT）对宫颈肌张力障碍（CD）焦虑的独特影响。
方法：在这项前瞻性观察研究中，从诊所招募了60名特发性孤立CD患者。我们使用多伦多西部痉挛斜颈评定量表（TWSTRS）I-III部分和状态特质焦虑量表（STAI）评估运动和焦虑负担。在BoNT时(基线)和注射后6周进行评估。
结果：在基线就诊时，STAI和运动严重程度TWSTRS评分相关性较差（rho=-0.30，p=0.411）。两者,运动TWSTRS(Mdifference=-1.46,p<0.024)和STAI(Mdifference=-10.37,p=0.007)从基线改善至6周(峰值效应)。运动TWSTRS的变化与基线访视至6周时焦虑评分的变化相关性较差(rho=-0.14,p>0.999)。在这些焦虑的衡量标准中，STAI-T的改善具有最大的效应大小(等级二元=0.52)。
结论：BoNT可改善CD中的运动严重程度和焦虑。在注射时间和峰值效应期间，运动严重程度与焦虑之间的相关性较差。特质焦虑的改善表明BoNT对焦虑有直接的有益作用。
方法：在这项前瞻性观察研究中，从诊所招募了60名特发性孤立CD患者。我们使用多伦多西部痉挛斜颈评定量表（TWSTRS）I-III部分和状态特质焦虑量表（STAI）评估运动和焦虑负担。在BoNT时(基线)和注射后6周进行评估。
结果：在基线就诊时，STAI和运动严重程度TWSTRS评分相关性较差（rho=-0.30，p=0.411）。两者,运动TWSTRS(Mdifference=-1.46,p<0.024)和STAI(Mdifference=-10.37,p=0.007)从基线改善至6周(峰值效应)。运动TWSTRS的变化与基线访视至6周时焦虑评分的变化相关性较差(rho=-0.14,p>0.999)。在这些焦虑的衡量标准中，STAI-T的改善具有最大的效应大小(等级二元=0.52)。
结论：BoNT可改善CD中的运动严重程度和焦虑。在注射时间和峰值效应期间，运动严重程度与焦虑之间的相关性较差。特质焦虑的改善表明BoNT对焦虑有直接的有益作用。
