Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis

Giovanni Defazio¹, Angelo F Gigante², Mark Hallett³, Alfredo Berardelli⁴, Joel S Perlmutter⁵, Brian D Berman⁶, Joseph Jankovic⁷, Tobias Bäumer⁸, Cynthia Comella⁹, Tommaso Ercoli¹, Gina Ferrazzano¹⁰, Susan H Fox¹¹, Han-Joon Kim¹², Emile Sami Moukheiber¹³, Sarah Pirio Richardson¹⁴, Anne Weissbach¹⁵, Hyder A Jinnah¹⁶

Affiliations

¹ Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
² Section of Neurology, San Paolo Hospital, Bari, Italy. Electronic address: angelo.gigante@yahoo.it.
³ Human Motor Control Section, NINDS, NIH, Bethesda, MD, USA.
⁴ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS NEUROMED, Pozzilli, Italy.
⁵ Neurology, Radiology, Neuroscience, Physical Therapy, Occupational Therapy, Washington University in St. Louis, St Louis, MO, USA.
⁶ Virginia Commonwealth University, Richmond, VA, USA.
⁷ Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
⁸ Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany.
⁹ Rush University Medical Center, New Philadelphia, OH, USA.
¹⁰ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
¹¹ Toronto Western Hospital, Krembil Brain Institute, University of Toronto, Canada.
¹² Department of Neurology and Movement Disorder Centre, Seoul National University Hospital, Seoul, South Korea.
¹³ Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
¹⁴ Department of Neurology, University of New Mexico, Albuquerque, NM, USA.
¹⁵ Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA; Institute of Systems Motor Science and Institute of Neurogenetics, University of Lübeck, Germany.
¹⁶ Department of Neurology and Human Genetics, Emory University, Atlanta, GA, USA.

PMID: 36306537
PMCID: PMC11187571
DOI: 10.1016/j.parkreldis.2022.10.008

Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis

Giovanni Defazio et al. Parkinsonism Relat Disord. 2022 Nov.

. 2022 Nov:104:94-98.

doi: 10.1016/j.parkreldis.2022.10.008. Epub 2022 Oct 13.

Authors

Affiliations

¹ Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
² Section of Neurology, San Paolo Hospital, Bari, Italy. Electronic address: angelo.gigante@yahoo.it.
³ Human Motor Control Section, NINDS, NIH, Bethesda, MD, USA.
⁴ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS NEUROMED, Pozzilli, Italy.
⁵ Neurology, Radiology, Neuroscience, Physical Therapy, Occupational Therapy, Washington University in St. Louis, St Louis, MO, USA.
⁶ Virginia Commonwealth University, Richmond, VA, USA.
⁷ Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
⁸ Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany.
⁹ Rush University Medical Center, New Philadelphia, OH, USA.
¹⁰ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
¹¹ Toronto Western Hospital, Krembil Brain Institute, University of Toronto, Canada.
¹² Department of Neurology and Movement Disorder Centre, Seoul National University Hospital, Seoul, South Korea.
¹³ Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
¹⁴ Department of Neurology, University of New Mexico, Albuquerque, NM, USA.
¹⁵ Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA; Institute of Systems Motor Science and Institute of Neurogenetics, University of Lübeck, Germany.
¹⁶ Department of Neurology and Human Genetics, Emory University, Atlanta, GA, USA.

PMID: 36306537
PMCID: PMC11187571
DOI: 10.1016/j.parkreldis.2022.10.008

Abstract

Introduction: Idiopathic blepharospasm is a clinically heterogeneous dystonia also characterized by non motor symptoms.

Methods: We used a k-means cluster analysis to assess 188 patients with idiopathic blepharospasm in order to identify relatively homogeneous subpopulations of patients, using a set of motor and psychiatric variables to generate the cluster solution.

Results: Blepharospasm patients reached higher scores on scales assessing depressive- and anxiety-related disorders than healthy/disease controls. Cluster analysis suggested the existence of three groups of patients that differed by type of spasms, overall motor severity, and presence/severity of psychiatric problems. The greater severity of motor symptoms was observed in Group 1, the least severity in Group 3, while the severity of blepharospasm in Group 2 was between that observed in Groups 1 and 3. The three motor subtypes also differed by psychiatric features: the lowest severity of psychiatric symptoms was observed in the group with least severe motor symptoms (group 3), while the highest psychiatric severity scores were observed in group 2 that carried intermediate motor severity rather than in the group with more severe motor symptoms (group 1). The three groups did not differ by disease duration, age of onset, sex or other clinical features.

Conclusions: The present study suggests that blepharospasm patients may be classified in different subtypes according to the type of spasms, overall motor severity and presence/severity of depressive symptoms and anxiety.

Keywords: Anxiety; Blepharospasm; Cluster analysis; Depression.

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Conflict of interest statement

Disclosures relevant to this work: The authors declare that there are no conflicts of interest relevant to this work. All authors have approved the final manuscript.

References

1. Defazio G, Hallett M, Jinnah HA, Conte A, Berardelli A. Blepharospasm 40 years later. Mov Disord. 2017. Apr;32(4):498–509. - PMC - PubMed
1. Berman BD, Junker J, Shelton E, et al.. Psychiatric associations of adult-onset focal dystonia phenotypes. J Neurol Neurosurg Psychiatry. 2017. Jul;88(7):595–602. - PMC - PubMed
1. Defazio G, Conte A, Gigante AF, et al. Clinical heterogeneity in patients with idiopathic blepharospasm: A cluster analysis. Parkinsonism Relat Disord. 2017. Jul;40:64–68. - PubMed
1. Defazio G, Jinnah HA, Berardelli A, et al. Diagnostic criteria for blepharospasm: a multicenter international study. Parkinsonism Relat Disord. 2021. Oct;91:109–114. - PMC - PubMed
1. Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013. Jun 15;28(7):863–73. - PMC - PubMed

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Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis

Affiliations

Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources