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Article

Cognitive Rehabilitation as a Possible Therapeutic Approach in Patients with Blepharospasm

by
Francesco Marchet
1,2,
Daniele Belvisi
1,2,
Giorgio Leodori
1,2,
Flavia Aiello
1,
Matteo Costanzo
3,
Federica Satriano
1,
Antonella Di Vita
1,
Antonella Conte
1,2,
Giovanni Fabbrini
1,2,* and
Gina Ferrazzano
1
1
Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, RM, Italy
2
IRCCS Neuromed, via Atinense 18, 86077 Pozzilli, IS, Italy
3
Department of Neuroscience, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, RM, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(8), 2574; https://doi.org/10.3390/jcm14082574
Submission received: 3 March 2025 / Revised: 28 March 2025 / Accepted: 5 April 2025 / Published: 9 April 2025
(This article belongs to the Special Issue Non-Motor Symptoms in Movement Disorders)
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Abstract

Background/Objectives: 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. Methods: 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. Results: Both groups exhibited a significant reduction in BR at T1 (p = 0.001), but Group A exhibited a greater improvement in BR (45.4%) compared to that of Group B (12.6%, p = 0.04). Reading and writing tasks were the most effective in reducing BR and dystonic spasms (p < 0.001). No significant correlation was found between the clinical and demographic features (p > 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.
Keywords: blepharospasm; cognitive training; writing; reading; dystonia; blink rate blepharospasm; cognitive training; writing; reading; dystonia; blink rate

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MDPI and ACS Style

Marchet, F.; Belvisi, D.; Leodori, G.; Aiello, F.; Costanzo, M.; Satriano, F.; Di Vita, A.; Conte, A.; Fabbrini, G.; Ferrazzano, G. Cognitive Rehabilitation as a Possible Therapeutic Approach in Patients with Blepharospasm. J. Clin. Med. 2025, 14, 2574. https://doi.org/10.3390/jcm14082574

AMA Style

Marchet F, Belvisi D, Leodori G, Aiello F, Costanzo M, Satriano F, Di Vita A, Conte A, Fabbrini G, Ferrazzano G. Cognitive Rehabilitation as a Possible Therapeutic Approach in Patients with Blepharospasm. Journal of Clinical Medicine. 2025; 14(8):2574. https://doi.org/10.3390/jcm14082574

Chicago/Turabian Style

Marchet, Francesco, Daniele Belvisi, Giorgio Leodori, Flavia Aiello, Matteo Costanzo, Federica Satriano, Antonella Di Vita, Antonella Conte, Giovanni Fabbrini, and Gina Ferrazzano. 2025. "Cognitive Rehabilitation as a Possible Therapeutic Approach in Patients with Blepharospasm" Journal of Clinical Medicine 14, no. 8: 2574. https://doi.org/10.3390/jcm14082574

APA Style

Marchet, F., Belvisi, D., Leodori, G., Aiello, F., Costanzo, M., Satriano, F., Di Vita, A., Conte, A., Fabbrini, G., & Ferrazzano, G. (2025). Cognitive Rehabilitation as a Possible Therapeutic Approach in Patients with Blepharospasm. Journal of Clinical Medicine, 14(8), 2574. https://doi.org/10.3390/jcm14082574

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