Zhang Hui-Na, Gao Qi, Xie Jia-Jun, Ye Juan
Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Int J Ophthalmol. 2024 Nov 18;17(11):2007-2013. doi: 10.18240/ijo.2024.11.05. eCollection 2024.
To investigate the relationship between benign essential blepharospasm (BEB) symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin type A (BoNT/A) can impact psychological symptoms.
This prospective interventional case series recruited 61 adults with evidence of BEB. Patients were administered the Jankovic Rating Scale (JRS), the Blepharospasm Disability Index (BSDI), Personal Health Questionnaire Depression Scale (PHQ-8), Generalized Anxiety Disorder 7-item scale (GAD-7) and the Athens insomnia scale (AIS) to evaluate the severity of BEB symptoms, depression, anxiety and sleep disorder before and 1wk, 1, 3mo after the BoNTA treatment. Statistical analysis was performed to assess the relationships between changes in the survey scores.
The mean score for JRS, BSDI, PHQ-8, and GAD-7 improved significantly (<0.0001), respectively, compared to the initial visit at follow-up. At baseline, worse BSDI scores were correlated with worse GAD-7 and PHQ-8, but not with worse AIS. At 1mo follow-up visit, there was no correlation between change in BSDI and PHQ-8/AIS, the change in GAD-7 showed a mild association with change in BSDI. The change in BSDI was correlated with the change in both PHQ-8 and GAD-7 in the subgroup of patients without a prior diagnosis of depression or anxiety. Patient satisfaction with BoNT/A treatment reached the highest at 1mo of follow-up (83.6%, 51/61).
BEB may lead to psychological diseases. BoNT/A can significantly improve motor and non-motor symptoms of BEB, which emphasize the effectiveness of BoNT/A and therefore pave the way for its use in the field of psychiatry. However, further research is needed to confirm these findings and understand the underlying mechanisms.
以前瞻性方式研究良性原发性眼睑痉挛（BEB）症状与抑郁/焦虑/睡眠障碍之间的关系，并确定用A型肉毒杆菌毒素（BoNT/A）治疗BEB是否会影响心理症状。
本前瞻性干预性病例系列招募了61名有BEB证据的成年人。患者在BoNTA治疗前、治疗后1周、1个月和3个月接受扬科维奇评定量表（JRS）、眼睑痉挛残疾指数（BSDI）、个人健康问卷抑郁量表（PHQ-8）、广泛性焦虑障碍7项量表（GAD-7）和雅典失眠量表（AIS），以评估BEB症状、抑郁、焦虑和睡眠障碍的严重程度。进行统计分析以评估调查分数变化之间的关系。
与随访时的初次就诊相比，JRS、BSDI、PHQ-8和GAD-7的平均得分分别显著改善（<0.0001）。在基线时，较差的BSDI得分与较差的GAD-7和PHQ-8相关，但与较差的AIS无关。在1个月随访时，BSDI的变化与PHQ-8/AIS之间无相关性，GAD-7的变化与BSDI的变化有轻度关联。在未预先诊断为抑郁或焦虑的患者亚组中，BSDI的变化与PHQ-8和GAD-7的变化均相关。患者对BoNT/A治疗的满意度在随访1个月时达到最高（83.6%，51/61）。
BEB可能导致心理疾病。BoNT/A可显著改善BEB的运动和非运动症状，这强调了BoNT/A的有效性，因此为其在精神病学领域的应用铺平了道路。然而，需要进一步研究来证实这些发现并了解潜在机制。
