Abstract
Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson’s disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available.
Highlights
Dystonia is a neurological movement disorder in which sustained or intermittent muscle contractions result in abnormal, often repetitive movements, and/or postures
Since sexual functioning is an important aspect of mental health (World Association for Sexual Health [WAS], 2008), and it has been found to be deficient in neurological patients with other types of movement disorders, in the current study, we investigated whether dystonic patients with BSP and spasmodic torticollis (ST) may experience a worsening of their sexual life
The ANOVAs revealed a main effect of the factor GROUP for Beck Depression Inventory (BDI) [F(3,112) = 9.845, p < 0.001, η2p = 0.209], State-Trait Anxiety Inventory (STAI)-X1 [F(3,112) = 10.476, p < 0.001, η2p = 0.219], STAIX2 [F(3,112) = 10.702, p < 0.001, η2p = 0.223]
Summary
Dystonia is a neurological movement disorder in which sustained or intermittent muscle contractions result in abnormal, often repetitive movements, and/or postures. BSP is a focal dystonia characterized by bilateral involuntary contraction of orbicularis oculi muscles with the consequence of continuous or intermittent forceful closure of the eyelids (Dashtipour et al, 2015). Neural circuits underlying the pathophysiology of BSP involve the basal ganglia, the thalamus, and the peduncle-mesencephalic area (Defazio et al, 2007). ST is the most common form of idiopathic focal dystonia and is characterized by intermittent or sustained deviation of the neck, accompanied by pain. The pathophysiology of ST seems to involve the basal ganglia and their connections to cortical areas (Jinnah et al, 2013; Avanzino and Fiorio, 2014)
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