Abstract

Idiopathic blepharospasm shows a female predominance in prevalence, whether there are sex-related differences in distributions of nonmotor symptoms (NMSs) and predictors of quality of life are unknown. Four hundred and twenty-five patients with idiopathic blepharospasm were consecutively recruited, and underwent assessments including dystonia severity, mood disturbances, sleep disturbances, cognition, ocular symptoms, and quality of life. Frequencies and distributions of NMSs, and predictors of quality of life in female and male patients were investigated. NMSs existed in majority of male (94.0%) and female (95.8%) patients. The frequencies of depression, cognition dysfunction, and poor sleep quality were higher in female patients, while the frequency of excessive daytime sleepiness was higher in male patients. More female (79.5%) patients had multiple NMS domains affected than male (70.1%) patients (p = 0.040). Quality of life was associated with depression, anxiety and motor severity for female patients (adjusted R2 = 0.367, p < 0.001), while associated with depression, excessive daytime sleepiness and motor severity for male patients (adjusted R2 = 0.430, p < 0.001). The highly prevalent coexistence of multiple NMSs found in patients with blepharospasm support that blepharospasm is a network disorder. The sex-related differences in the pattern of NMSs and predictors of quality of life may aid the development of tailored management of blepharospasm.

Highlights

  • In a large cohort of BSP patients, coexistence of multiple nonmotor symptoms (NMSs) were highly prevalent in all patients, and a higher prevalence of depression, poor sleep quality, and cognitive dysfunction were found in female patients, while EDS was more prevalent in male patients

  • health related quality of life (HRQoL) was significantly correlated with motor and nonmotor symptoms in BSP patients

  • We found female BSP patients being significantly more depressed than male patients, even after adjusting for the motor severity, which was consistent with the previous ­study[2]

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Summary

Objectives

We aimed to explore differences in the severity and frequency of NMSs and coexistence of multiple NMSs regarding to sex, and to investigate the most important determinants of HRQoL in idiopathic BSP patients

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