【 文献重点摘要 】

Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson’ s disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available.

Keywords

dystonia, hemifacial spasm, sexual function, depression, anxiety

情绪、焦虑和其他心理症状在患有眼睑痉挛(BSP)和痉挛性斜颈(ST)的肌张力障碍患者中是常见的。由于性健康是精神健康的一个重要方面，在这里，我们调查了这些患者是否也会经历性生活恶化。特别是对BSP患者(N=30)、ST患者(N=30)和面肌痉挛患者(HFS；N=30)的性生活质量进行了评估，并与接受A型肉毒毒素治疗的面肌痉挛患者(HFS；N=30)进行了对照。30名年龄匹配的健康志愿者组成另一个对照组。就在定期注射肉毒杆菌毒素之前，对患者进行了评估。性功能是使用性功能清单(Golombok Rust Inventory)的一种简化形式来评估性功能的，该清单以前用于帕金森氏症患者。同时评定抑郁(贝克抑郁量表)和焦虑(STAI-X1/X2)。结果显示，与健康对照组相比，BSP、ST和HFS患者的性功能受到显著影响。肌张力障碍患者比HFS患者表现出更多的性功能障碍。总体而言，女性的性生活质量比男性更差，在女性中，患有BSP的女性功能最不正常。肌张力障碍患者有心理症状，而HFS患者没有。正如本文所讨论的，可以考虑几个因素来解释肌张力障碍患者的性生活质量比面肌痉挛患者差。其中，肌张力障碍病理生理的中枢起源(即皮层-纹状体-丘脑-皮质环路的活动改变)可能起着重要作用。考虑到这是第一次在BSP、ST和HFS患者中评估性健康状况，并且没有可比的数据，进一步的调查是必要的，以进一步探索这些初步发现。

关键词

肌张力障碍、面肌痉挛、性功能、抑郁、焦虑