Object:We performed a prospective study in 48 patients to evaluate the impact of botulinum toxin (BT) therapy on mental symptoms in patients affected by spasticity and focal dystonia. Method: 21 patients affected by spasticity (I group) and 27 patients affected by focal dystonia (II group) were included in the study. The patients were evaluated at baseline and 3 and 6 months after treatment; we studied the clinical effect of BT with Tsui and Columbia test in II group and with Medical Research Council Scale (MRC) and Modified Ashworth Scale in I group; all the patients were evaluated by center epidemiological study depression (CES-D), brief symptoms inventory (BSI) and attachment style questionnaire (ASQ); the II group by IIP-64, family apgar score (FAS), global clinical rating scale (GCRS), while the I group by short form-12 health survey questionnaire (SF-12); spastic patients’ caregivers were examined by CES-D and CBI. A total of 17 patients (10 with dystonia and 7 with spasticity) completed the follow up. Patients were treated with BT type A (Botox-Allergan USA, Dysport-Ipsen UK) at dosage ranging from 350 to 1,000 mouse Units (mU) for Dysport BT and 10 to 100 mU for Botox BT. Results: in patients with spasticity a positive trend was observed in CES-D whilst no differences were observed in caregivers before and after BT treatment. In dystonic patients we observed a reduction in global stress index in BSI after BT and no difference in CES-D while neurological scales showed an improvement after therapy. In conclusion psycopathological assessment is crucial in evaluating BT therapy benefits in addition to neurological evaluation.
Impact on mental symptoms of botulinum toxin type A therapy in patients affected by focal dystonia and spasticity: preliminary results
OSTACOLI, Luca;FURLAN, Piermaria;DURELLI, Luca
2004-01-01
Abstract
Object:We performed a prospective study in 48 patients to evaluate the impact of botulinum toxin (BT) therapy on mental symptoms in patients affected by spasticity and focal dystonia. Method: 21 patients affected by spasticity (I group) and 27 patients affected by focal dystonia (II group) were included in the study. The patients were evaluated at baseline and 3 and 6 months after treatment; we studied the clinical effect of BT with Tsui and Columbia test in II group and with Medical Research Council Scale (MRC) and Modified Ashworth Scale in I group; all the patients were evaluated by center epidemiological study depression (CES-D), brief symptoms inventory (BSI) and attachment style questionnaire (ASQ); the II group by IIP-64, family apgar score (FAS), global clinical rating scale (GCRS), while the I group by short form-12 health survey questionnaire (SF-12); spastic patients’ caregivers were examined by CES-D and CBI. A total of 17 patients (10 with dystonia and 7 with spasticity) completed the follow up. Patients were treated with BT type A (Botox-Allergan USA, Dysport-Ipsen UK) at dosage ranging from 350 to 1,000 mouse Units (mU) for Dysport BT and 10 to 100 mU for Botox BT. Results: in patients with spasticity a positive trend was observed in CES-D whilst no differences were observed in caregivers before and after BT treatment. In dystonic patients we observed a reduction in global stress index in BSI after BT and no difference in CES-D while neurological scales showed an improvement after therapy. In conclusion psycopathological assessment is crucial in evaluating BT therapy benefits in addition to neurological evaluation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.