{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:07:59Z","timestamp":1790230079675,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,5]],"date-time":"2016-12-05T00:00:00Z","timestamp":1480896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nonmotor symptoms (<jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content>) are highly prevalent in cervical dystonia (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>). In general, fatigue and sleep are important <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content> that determine a decreased health\u2010related quality of life (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010QoL), but their influence in <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> is unknown. The authors systematically investigated fatigue, excessive daytime sleepiness (<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>), and sleep quality in patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and controls and assessed the influence of psychiatric comorbidity, pain, and dystonia motor severity. They also examined the predictors of <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010QoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 44 patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and 43 matched controls. Fatigue, <jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>, and sleep quality were assessed with quantitative questionnaires and corrected for depression and anxiety using analysis of covariance. The Toronto Western Spasmodic Torticollis Rating Scale and the Clinical Global Impression Scale\u2010jerks\/tremor subscale were used to score motor severity and to assess whether motor characteristics could explain an additional part of the variation in fatigue and sleep\u2010related measures. <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010QoL was determined with the <jats:styled-content style=\"fixed-case\">RAND<\/jats:styled-content>\u201036 item Health Survey, and predictors of <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010QoL were assessed using multiple regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fatigue scores were increased independently from psychiatric comorbidity (4.0 vs. 2.7; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01), whereas <jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content> (7.3 vs. 7.4; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.95) and sleep quality (6.5 vs. 6.1; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.73) were highly associated with depression and anxiety. In patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, motor severity did not explain the variations in fatigue (change in the correlation coefficient [\u0394R<jats:sup>2<\/jats:sup>]\u00a0=\u00a00.06; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.15), <jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content> (\u0394R<jats:sup>2<\/jats:sup>\u00a0=\u00a00.00; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.96), or sleep quality (\u0394R<jats:sup>2<\/jats:sup>\u00a0=\u00a00.04; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.38) scores. Fatigue, <jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>, psychiatric comorbidity, and pain predicted a decreased QoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Independent from psychiatric comorbidity and motor severity, fatigue appeared to be a primary <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content>. Sleep\u2010related measures were highly associated with psychiatric comorbidity, but not with motor severity. Only <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content> predicted <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010QoL, which emphasizes the importance of attention to <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content> in patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12459","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T10:56:54Z","timestamp":1479293814000},"page":"517-523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Fatigue, Sleep Disturbances, and Their Influence on Quality of Life in Cervical Dystonia Patients"],"prefix":"10.1002","volume":"4","author":[{"given":"Marenka","family":"Smit","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Groningen University of Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwen S. J.","family":"Kamphuis","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen University of Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna L.","family":"Bartels","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen University of Groningen Groningen the Netherlands"},{"name":"Department of Neurology Ommelander Hospital Group Delfzijl the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology Safarik University Kosice Slovakia"},{"name":"Department of Neurology University Hospital L. Pasteur Kosice Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy E.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Community and Occupational Medicine University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Zijdewind","sequence":"additional","affiliation":[{"name":"Department of Neuroscience University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina A.","family":"Tijssen","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen University of Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr224"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25501"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.04.004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5060-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.5.608"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827f07be"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/00207454.2015.1085035"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.baga.2014.10.002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.01.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.06.004"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1989.00520460115022"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(61)80020-5"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.6.893"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm0302_2"},{"key":"e_1_2_6_18_1","first-page":"211","volume-title":"Therapy with Botulinum Toxin","author":"Consky E","year":"1994"},{"key":"e_1_2_6_19_1","first-page":"218","volume-title":"ECDEU Assessment Manual for Psychopharmacology\u2010Revised","author":"Guy W","year":"1976"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e32832d9ef3"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.03.015"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq268"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6029-6"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmdc3.12459","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmdc3.12459","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.12459","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:13:42Z","timestamp":1760962422000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.12459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,5]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1002\/mdc3.12459"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.12459","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,5]]},"assertion":[{"value":"2016-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}