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Non-motor symptoms and quality of life in dopa-responsive dystonia patients

Timmers, E. R. ; Kuiper, A. ; Smit, M. ; Bartels, A. L. ; Kamphuis, D. J. ; Wolf, N. I. ; Poll-The, B. T. ; Wassenberg, T. ; Peeters, E. A.J. and de Koning, T. J. LU , et al. (2017) In Parkinsonism and Related Disorders 45. p.57-62
Abstract

Background In patients with GTP-cyclohydrolase deficient dopa-responsive dystonia (DRD) the occurrence of associated non-motor symptoms (NMS) is to be expected. Earlier studies report conflicting results with regard to the nature and severity of NMS. The aim of our study was to investigate the prevalence of psychiatric disorders, sleep problems, fatigue and health-related quality of life (HR-QoL) in a Dutch DRD cohort. Methods Clinical characteristics, motor symptoms, type and severity of psychiatric co-morbidity, sleep problems, fatigue and HR-QoL were assessed in DRD patients with a confirmed GCH1 mutation and matched controls. Results Twenty-eight patients were included (18 adults and 10 children), from 10 families. Dystonia symptoms... (More)

Background In patients with GTP-cyclohydrolase deficient dopa-responsive dystonia (DRD) the occurrence of associated non-motor symptoms (NMS) is to be expected. Earlier studies report conflicting results with regard to the nature and severity of NMS. The aim of our study was to investigate the prevalence of psychiatric disorders, sleep problems, fatigue and health-related quality of life (HR-QoL) in a Dutch DRD cohort. Methods Clinical characteristics, motor symptoms, type and severity of psychiatric co-morbidity, sleep problems, fatigue and HR-QoL were assessed in DRD patients with a confirmed GCH1 mutation and matched controls. Results Twenty-eight patients were included (18 adults and 10 children), from 10 families. Dystonia symptoms were well-controlled in all patients. According to the DSM IV patients significantly more often met the criteria for a lifetime psychiatric disorder than controls (61% vs. 29%, p < 0.05). In particular the frequencies of generalized anxiety and agoraphobia were higher in patients (both 29% vs. 4%, p < 0.05). Patients scored significantly higher on daytime sleepiness than controls (ESS, 11.2 vs 5.7, p < 0.05). Adult patients had significantly lower scores on the mental component of the HR-QoL (47 vs. 54, p < 0.05) than controls mainly associated with (worse) quality of sleep. Conclusion NMS were highly prevalent in our cohort of DRD patients, despite adequate treatment of motor symptoms. Our findings support the accumulating evidence of an important non-motor phenotype in DRD, with possible involvement of serotonergic mechanisms. This highlights the need to address NMS and the underlying neurobiology in patients with DRD.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dopa-responsive dystonia, Fatigue, GTP-cyclohydrolase deficiency, Health-related quality of life, Non-motor symptoms, Psychiatry, Sleep
in
Parkinsonism and Related Disorders
volume
45
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85040753257
  • pmid:29066160
ISSN
1353-8020
DOI
10.1016/j.parkreldis.2017.10.005
language
English
LU publication?
no
id
645ccfe2-929c-46f6-b443-ef5a0033f694
date added to LUP
2020-02-26 09:47:11
date last changed
2024-04-17 05:33:38
@article{645ccfe2-929c-46f6-b443-ef5a0033f694,
  abstract     = {{<p>Background In patients with GTP-cyclohydrolase deficient dopa-responsive dystonia (DRD) the occurrence of associated non-motor symptoms (NMS) is to be expected. Earlier studies report conflicting results with regard to the nature and severity of NMS. The aim of our study was to investigate the prevalence of psychiatric disorders, sleep problems, fatigue and health-related quality of life (HR-QoL) in a Dutch DRD cohort. Methods Clinical characteristics, motor symptoms, type and severity of psychiatric co-morbidity, sleep problems, fatigue and HR-QoL were assessed in DRD patients with a confirmed GCH1 mutation and matched controls. Results Twenty-eight patients were included (18 adults and 10 children), from 10 families. Dystonia symptoms were well-controlled in all patients. According to the DSM IV patients significantly more often met the criteria for a lifetime psychiatric disorder than controls (61% vs. 29%, p &lt; 0.05). In particular the frequencies of generalized anxiety and agoraphobia were higher in patients (both 29% vs. 4%, p &lt; 0.05). Patients scored significantly higher on daytime sleepiness than controls (ESS, 11.2 vs 5.7, p &lt; 0.05). Adult patients had significantly lower scores on the mental component of the HR-QoL (47 vs. 54, p &lt; 0.05) than controls mainly associated with (worse) quality of sleep. Conclusion NMS were highly prevalent in our cohort of DRD patients, despite adequate treatment of motor symptoms. Our findings support the accumulating evidence of an important non-motor phenotype in DRD, with possible involvement of serotonergic mechanisms. This highlights the need to address NMS and the underlying neurobiology in patients with DRD.</p>}},
  author       = {{Timmers, E. R. and Kuiper, A. and Smit, M. and Bartels, A. L. and Kamphuis, D. J. and Wolf, N. I. and Poll-The, B. T. and Wassenberg, T. and Peeters, E. A.J. and de Koning, T. J. and Tijssen, M. A.J.}},
  issn         = {{1353-8020}},
  keywords     = {{Dopa-responsive dystonia; Fatigue; GTP-cyclohydrolase deficiency; Health-related quality of life; Non-motor symptoms; Psychiatry; Sleep}},
  language     = {{eng}},
  month        = {{12}},
  pages        = {{57--62}},
  publisher    = {{Elsevier}},
  series       = {{Parkinsonism and Related Disorders}},
  title        = {{Non-motor symptoms and quality of life in dopa-responsive dystonia patients}},
  url          = {{http://dx.doi.org/10.1016/j.parkreldis.2017.10.005}},
  doi          = {{10.1016/j.parkreldis.2017.10.005}},
  volume       = {{45}},
  year         = {{2017}},
}