Marchet Francesco, Belvisi Daniele, Leodori Giorgio, Aiello Flavia, Costanzo Matteo, Satriano Federica, Di Vita Antonella, Conte Antonella, Fabbrini Giovanni, Ferrazzano Gina
Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, RM, Italy.
IRCCS Neuromed, via Atinense 18, 86077 Pozzilli, IS, Italy.
J Clin Med. 2025 Apr 9;14(8):2574. doi: 10.3390/jcm14082574.
Blepharospasm (BSP) is a focal dystonia characterized by involuntary, bilateral spasms of the orbicularis oculi muscle. While botulinum toxin (BoNT) is the standard treatment, cognitive tasks such as reading and writing may exert transient modulatory effects on spontaneous blinking and dystonic spasms. This study investigates the potential of cognitive training, including reading and writing tasks, as a complementary therapeutic approach to BoNT in BSP patients. A total of 16 BSP patients were randomly assigned to two groups: Group A (n = 6) received cognitive training alongside BoNT, while Group B (n = 10) received only BoNT. Cognitive training included structured reading and writing exercises over three months. Blink rate (BR) and dystonic spasms were assessed at baseline (T0), one month (T1), and three months (T2) post-treatment. Both groups exhibited a significant reduction in BR at T1 ( = 0.001), but Group A exhibited a greater improvement in BR (45.4%) compared to that of Group B (12.6%, = 0.04). Reading and writing tasks were the most effective in reducing BR and dystonic spasms ( < 0.001). No significant correlation was found between the clinical and demographic features ( > 0.05). Conclusions: Cognitive training significantly enhances the therapeutic effects of BoNT on BR in BSP patients, suggesting its potential as a non-invasive complementary intervention. These preliminary findings warrant further investigation using larger cohorts and employing neurophysiological assessments.
眼睑痉挛（BSP）是一种局灶性肌张力障碍，其特征为眼轮匝肌的双侧非自主性痉挛。虽然肉毒杆菌毒素（BoNT）是标准治疗方法，但诸如阅读和写作等认知任务可能会对自发性眨眼和肌张力障碍性痉挛产生短暂的调节作用。本研究调查了包括阅读和写作任务在内的认知训练作为BSP患者BoNT辅助治疗方法的潜力。共有16名BSP患者被随机分为两组：A组（n = 6）在接受BoNT治疗的同时接受认知训练，而B组（n = 10）仅接受BoNT治疗。认知训练包括为期三个月的结构化阅读和写作练习。在治疗前基线（T0）、治疗后1个月（T1）和3个月（T2）评估眨眼率（BR）和肌张力障碍性痉挛。两组在T1时BR均显著降低（P = 0.001），但A组BR的改善程度（45.4%）大于B组（12.6%，P = 0.04）。阅读和写作任务在降低BR和肌张力障碍性痉挛方面最有效（P < 0.001）。未发现临床和人口统计学特征之间存在显著相关性（P > 0.05）。结论：认知训练显著增强了BoNT对BSP患者BR的治疗效果，表明其作为非侵入性辅助干预措施的潜力。这些初步发现值得使用更大的队列并采用神经生理学评估进行进一步研究。
