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. 2025 May;46(5):2149-2157.
doi: 10.1007/s10072-025-08020-1. Epub 2025 Jan 30.

Effect of Botulinum toxin on non-motor symptoms in adult-onset idiopathic focal/segmental dystonia

Raghav Gupta  1 , Sahil Mehta  2 , Neeraj Balaini  3   4 , Kamalesh Chakravarty  3 , Jagdeep Singh  3 , Shivangi Mehta  5 , Sandeep Grover  6 , Vivek Lal  3
Affiliations

Effect of Botulinum toxin on non-motor symptoms in adult-onset idiopathic focal/segmental dystonia

Raghav Gupta et al. Neurol Sci. 2025 May.

Abstract

Background: Non-motor symptoms, including depression, anxiety, sleep disturbances, pain and cognitive dysfunction, are a much more important predictor of quality of life than the severity of dystonia.

Objectives: To assess the effect of Botulinum toxin on non-motor symptoms and quality of life in patients with adult-onset idiopathic focal dystonia.

Methods: Patients aged > 18 years diagnosed with idiopathic focal dystonia were recruited in this longitudinal cohort study. The severity of dystonia, non-motor symptoms, and quality of life were evaluated using the BFMDRS, DNMSQuest, and EQ-5D at baseline and 1 and 3 months after botulinum toxin.

Results: 65 patients were recruited with a median age of 59 years. Blepharospasm was the most common phenomenology. 49.2% of patients had depression at baseline assessed using the Beck Depression Inventory (BDI). There was a significant negative correlation between baseline BFMDRS, DNMSQuest, BDI, and HAM-A scores and quality of life, but there was no relation with the type of focal dystonia. The mean percentage improvement in the BFMDRS-M, BFMDRS-D, DNMSQuest, BDI, HAM-A and EQ-5D was 25%, 52%, 16%,20%,23% and 23%, respectively, at one month. There was no statistically significant correlation between percentage change in motor scores compared to depression and quality of life scores at one month.

Conclusion: Botulinum toxin improved motor and non-motor scores and quality of life at 1 and 3 months after botulinum toxin therapy. The motor scores did not correlate with depression and DNMSQUEST scores but showed a weak positive correlation with anxiety scores.

Keywords: Anxiety; Botulinum Toxin; Depression; Dystonia; Non-Motor.

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Conflict of interest statement

Declarations. Ethical Approval: We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines. “The authors confirm that the approval of an institutional review board was not required for this work.” Informed consent: Was obtained and is being submitted with the manuscript. Conflict of Interest: The authors declare no conflicts of interest relevant to this work.

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