Relations between nonmotor manifestations and motor disorders in patients with benign essential blepharospasm
Relations between nonmotor manifestations and motor disorders in patients with benign essential blepharospasm
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DOI：
10.1007/s00417-023-06141-x
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发表时间：
2023-06-21
影响因子：
2.7
通讯作者：
Gong，Lan
中科院分区：
文献类型：
--
作者：
Zhou，Yemeng;Wang，Wushuang;Gong，Lan
目的探讨良性特发性眼睑痉挛(BEB)患者非运动表现(干眼、情绪障碍、睡眠障碍)与运动障碍的关系，以及肉毒神经毒素缓解运动障碍是否能改善BEB患者的非运动表现。其中28例接受肉毒神经毒素治疗，术后1个月和3个月再复诊2次。运动严重程度采用Jankovic评定量表(JRS)和眼球痉挛残疾指数(BSDI)进行评定。用OSDI问卷、Schirmer试验、泪液破裂时间(TBUT)、泪液半月板高度、脂层厚度(LLT)和角膜荧光染色等方法评价干眼症。结果干眼症和心境障碍患者的JRS评分(5.78 ± 1.13，5.97 ± 1.3)明显高于非干眼症患者(分别为5.12 ± 1.40，5.50 ± 1.16；P = 0.039，0.019)。有睡眠障碍患者的BSDI值(14.61 ± 4.71)高于无睡眠障碍患者(11.89 ± 5.44，P = 0.006)。JRS、BSDI与SAS、SDS、PSQI、OSDI、TBUT呈正相关。肉毒神经毒素治疗1个月后较治疗前(9.75 ± 5.60，33.58 ± 13.27，4.14 ± 2.21；S，62.33 ± 22.01 nm；P = 0.006， <； 0.001， = 0.027， <； 0.001)。结论伴有干眼、情绪障碍或睡眠障碍的BEB患者存在更严重的运动障碍。运动严重程度与非运动表现的严重程度相关。肉毒神经毒素缓解运动障碍能有效改善干眼和睡眠障碍。
PurposeTo evaluate the relations between nonmotor manifestations (dry eye, mood disorders, and sleep disturbance) and motor disorders in patients with benign essential blepharospasm (BEB), and to determine whether relieving motor disorders by botulinum neurotoxin can improve the nonmotor manifestations.MethodsIn this prospective case series study, 123 BEB patients were enrolled for evaluations. Among them, 28 patients underwent botulinum neurotoxin therapy and attended another two postoperative visits at 1 month and 3 months. Motor severity was measured with Jankovic Rating Scale (JRS) and Blepharospasm Disability Index (BSDI). We assessed dry eye using OSDI questionnaire, Schirmer test, tear break-up time (TBUT), tear meniscus height, lipid layer thickness (LLT) and corneal fluorescence staining. Zung’s Self-rating Anxiety and Depression Scale (SAS, SDS) and Pittsburgh Sleep Quality Index (PSQI) were for mood status and sleep quality evaluations.ResultsPatients with dry eye or mood disorders had higher JRS scores (5.78 ± 1.13, 5.97 ± 1.30) than those without (5.12 ± 1.40, 5.50 ± 1.16; P = 0.039, 0.019, respectively). BSDI values of patients with sleep disturbance (14.61 ± 4.71) was higher than those without (11.89 ± 5.44, P = 0.006). Correlations were found between JRS, BSDI and SAS, SDS, PSQI, OSDI, TBUT. Botulinum neurotoxin effectively relieved JRS, BSDI and improved PSQI, OSDI, TBUT, LLT (8.11 ± 5.81, 21.77 ± 15.76, 5.04 ± 2.15 s, 79.61 ± 24.11 nm) at the 1-month visit compared to baseline (9.75 ± 5.60, 33.58 ± 13.27, 4.14 ± 2.21 s, 62.33 ± 22.01 nm; P = 0.006, < 0.001, = 0.027, < 0.001, respectively).ConclusionsThe BEB patients with dry eye, mood disorders, or sleep disturbance had more severe motor disorders. Motor severity was associated with the severity of the nonmotor manifestations. Relieving motor disorders by botulinum neurotoxin was effective in improving dry eye and sleep disturbance.