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Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis

      Highlights

      • Psychiatric symptoms are part of the clinical spectrum of Idiopathic blepharospasm.
      • Depression and anxiety scores were higher in patients than in controls.
      • Cluster analysis with motor/psychiatric resulted in three groups of patients.
      • Lowest severity of psychiatric symptoms in the least severe motor symptoms' cluster.
      • Highest psychiatric severity scores in the intermediate motor severity cluster.

      Abstract

      Introduction

      Idiopathic blepharospasm is a clinically heterogeneous dystonia also characterized by non motor symptoms.

      Methods

      We used a k-means cluster analysis to assess 188 patients with idiopathic blepharospasm in order to identify relatively homogeneous subpopulations of patients, using a set of motor and psychiatric variables to generate the cluster solution.

      Results

      Blepharospasm patients reached higher scores on scales assessing depressive- and anxiety-related disorders than healthy/disease controls. Cluster analysis suggested the existence of three groups of patients that differed by type of spasms, overall motor severity, and presence/severity of psychiatric problems. The greater severity of motor symptoms was observed in Group 1, the least severity in Group 3, while the severity of blepharospasm in Group 2 was between that observed in Groups 1 and 3. The three motor subtypes also differed by psychiatric features: the lowest severity of psychiatric symptoms was observed in the group with least severe motor symptoms (group 3), while the highest psychiatric severity scores were observed in group 2 that carried intermediate motor severity rather than in the group with more severe motor symptoms (group 1). The three groups did not differ by disease duration, age of onset, sex or other clinical features.

      Conclusions

      The present study suggests that blepharospasm patients may be classified in different subtypes according to the type of spasms, overall motor severity and presence/severity of depressive symptoms and anxiety.

      Keywords

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