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The Dystonia Discomfort Scale ( DDS ): a novel instrument to monitor the temporal profile of botulinum toxin therapy in cervical dystonia
Author(s) -
Dressler D.,
Kupsch A.,
Seitzinger A.,
Paus S.
Publication year - 2014
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12330
Subject(s) - cervical dystonia , spasmodic torticollis , botulinum toxin , medicine , dystonia , rating scale , torticollis , physical therapy , physical medicine and rehabilitation , anesthesia , surgery , psychology , psychiatry , developmental psychology
Background and purpose Conventional scales measure the effect of botulinum toxin ( BT ) therapy only at specific points in time. The Dystonia Discomfort Scale ( DDS ), a novel, easy‐to‐use, self‐assessment scale to record temporal profiles of the effect of BT therapy in cervical dystonia ( CD ), is introduced and evaluated against the Toronto Western Spasmodic Torticollis Rating Scale ( TWSTRS ). Methods Seventy‐six patients with CD (age 54.4 ± 10.9 years, 34% male) receiving ≤5 cycles of incobotulinumtoxinA (Xeomin ® ; Merz Pharmaceuticals, Frankfurt am Main, Germany) injections at intervals ≥10 weeks used DDS to record the severity of their symptoms daily. DDS data were compared with TWSTRS ‐Total scores and patients' subjective estimation ( SE ) of the onset ( TO ) and waning ( TW ) of the treatment effect. Results The Toronto Western Spasmodic Torticollis Rating Scale − Total scores correlated significantly with DDS ( P ≤ 0.028 at all visits evaluated). TO ‐ DDS and TO ‐ SE were 7.9 ± 8.6 and 7.1 ± 4.1 days, respectively; TW ‐ DDS and TW ‐ SE were 41.8 ± 19.2 and 45.1 ± 21.5 days, respectively. Conclusion The Dystonia Discomfort Scale is a novel, easy‐to‐use, self‐assessment scale for valid and sensitive monitoring of the temporal profile of the effect of BT therapy in patients with CD . DDS provides important additional information about onset, duration, waning, stability and reproducibility of the effects of BT therapy.