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IN cervical dystonia botulinum neurotoxin injections improved sleep quality but did not ease anxiety or depression in adult cohort.
Why Nonmotor Symptoms Matter in Cervical Dystonia
Nonmotor symptoms can substantially shape day to day burden in cervical dystonia, yet evidence on whether botulinum neurotoxin injection improves these symptoms remains limited and mixed. A prospective cohort study evaluated changes in sleep quality, mood symptoms, and quality of life after intramuscular botulinum neurotoxin injections in adults receiving care through a university hospital clinic and a specialized private physiotherapy practice.
Botulinum Neurotoxin Injection Improved Sleep Quality
The cohort included 29 patients with cervical dystonia, with a mean age of 61.6 years. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. After treatment, the mean global Pittsburgh Sleep Quality Index score decreased from 10.1 at baseline to 7.41 post treatment, indicating improved sleep quality. The change was statistically significant, with a mean difference of 2.65.
These findings suggest sleep may be a particularly responsive nonmotor symptom following botulinum neurotoxin injection in cervical dystonia, at least in the short term window assessed in this cohort.
Mood Symptoms Did Not Significantly Change
Depression and anxiety were measured using the Beck Depression Inventory II and Beck Anxiety Inventory II. Anxiety scores decreased slightly from a mean of 13.5 at baseline to 12.52 post treatment. Depressive symptom scores showed little overall shift, with the median Beck Depression Inventory II score changing from 7 to 8. No statistically significant differences were observed in depressive or anxiety symptoms after treatment.
Quality of life was assessed with EuroQol 5 dimensions. The authors noted that persistent psychiatric symptoms may warrant complementary therapy alongside botulinum neurotoxin injection, and emphasized the need for larger controlled studies to further characterize effects on nonmotor symptoms in cervical dystonia.
Reference: Kassaye SG et al. The effect of botulinum neurotoxin injection on non-motor symptoms of cervical dystonia: A prospective cohort. Acta Neurol Belg. 2026;doi: 10.1007/s13760-026-03014-y.