Botulinum Toxin in Movement Disorders: An Update

Anandan, Charenya; Jankovic, Joseph

doi:10.3390/toxins13010042

Cited by 76 publications

(79 citation statements)

References 284 publications

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“…Indeed, in one study, 88% of patients treated with repeat BoNT injections for cervical dystonia experienced symptom re-emergence between injections, resulting in a so-called "rollercoaster" pattern 15 . A similar pattern has been previously reported in patients treated with BoNT for blepharospasm and other conditions 16 . In the previous pivotal trial of incobotulinumtoxinA for the treatment of blepharospasm, flexible treatment intervals (!6 weeks and <20 weeks) were used according to the individual's needs and at the physician's discretion 1,2 .…”

Section: Introductionsupporting

confidence: 88%

Duration and onset of effect of incobotulinumtoxinA for the treatment of blepharospasm in botulinum toxin-naïve subjects

Mitsikostas

Dekundy

Hanschmann

et al. 2021

Current Medical Research and Opinion

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Objective: Blepharospasm is a focal dystonia whereby excessive eyelid muscle contractions cause involuntary eye closure. Botulinum neurotoxin type A (BoNT-A) injections are an approved treatment. This randomized placebo-controlled trial (NCT01896895; EudraCT number 2012-004821-26) assessed the efficacy, safety, and treatment effect duration of incobotulinumtoxinA (Xeomin, Merz Pharmaceuticals GmbH), a BoNT-A formulation without complexing proteins, in BoNT-A-naïve adults with blepharospasm. Methods: Subjects received incobotulinumtoxinA 50 U, 25 U (total dose) or placebo during a main study period (MP; 6-20 weeks). Patients needing a second injection received incobotulinumtoxinA 70 U in an open-label extension period (EP; 6-20 weeks). Treatment effect durations were time from first injection to EP injection or final MP visit and from EP injection to end-of-study visit. Times to effect onset and to waning of effect (MP) were time from injection to first subject-assessed onset effect and time from injection to subject-reported waning of effect, respectively. Results: Of 61 subjects, 39 entered the EP. During the MP, median duration of treatment effect was longer with incobotulinumtoxinA 50 U (20 weeks) versus incobotulinumtoxinA 25 U (11 weeks) or placebo (6 weeks). Median duration of treatment effect was 20 weeks during the EP. Median time to effect onset was 5, 7, and 14 days with 50 U, 25 U, and placebo, respectively (p ¼ .022 for 50 U versus placebo). Median time to waning of treatment effect was comparable between groups. Conclusion: Subjects reported an effect onset from 5 days after injection lasting up to 20 weeks (maximum observation period). Data indicate that incobotulinumtoxinA re-treatment of blepharospasm may not be required at fixed 12-week intervals and provide evidence for a patient-tailored approach.

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Section: Introductionsupporting

confidence: 88%

Duration and onset of effect of incobotulinumtoxinA for the treatment of blepharospasm in botulinum toxin-naïve subjects

Mitsikostas

Dekundy

Hanschmann

et al. 2021

Current Medical Research and Opinion

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“…Subsequently, BoNT-A was approved in 1989 by the US Food and Drug Administration for the treatment of BSP and other facial spasms. BoNT-A was successfully evolved into a therapeutic modality for a variety of movements disorders including some motor symptoms in PD [ 190 ] such as dystonia [ 191 , 192 , 193 , 194 , 195 , 196 , 197 ], jaw tremors [ 198 ], limb rest tremor [ 198 , 199 , 200 ], freezing of gait [ 201 , 202 , 203 , 204 ], sialorrhea [ 197 , 205 , 206 , 207 , 208 , 209 ], overactive bladder [ 210 , 211 , 212 , 213 ], constipation [ 214 , 215 ], dyskinesias [ 192 ], captocormia [ 216 , 217 , 218 ], Pisa syndrome [ 219 , 220 ], dysphagia [ 221 , 222 ], apraxia of lid opening [ 223 , 224 ].…”

Section: Introductionmentioning

confidence: 99%

Antidepressant-Like Properties of Intrastriatal Botulinum Neurotoxin-A Injection in a Unilateral 6-OHDA Rat Model of Parkinson’s Disease

Antipova

Holzmann

Hawlitschka

et al. 2021

Toxins

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Parkinson’s patients often suffer from depression and anxiety, for which there are no optimal treatments. Hemiparkinsonian (hemi-PD) rats were used to test whether intrastriatal Botulinum neurotoxin-A (BoNT-A) application could also have antidepressant-like properties in addition to the known improvement of motor performance. To quantify depression- and anxiety-like behavior, the forced swim test, tail suspension test, open field test, and elevated plus maze test were applied to hemi-PD rats injected with BoNT-A or vehicle. Furthermore, we correlated the results in the forced swim test, open field test, and elevated plus maze test with the rotational behavior induced by apomorphine and amphetamine. Hemi-PD rats did not show significant anxiety-like behavior as compared with Sham 6-OHDA- + Sham BoNT-A-injected as well as with non-injected rats. However, hemi-PD rats demonstrated increased depression-like behaviors compared with Sham- or non-injected rats; this was seen by increased struggling frequency and increased immobility frequency. Hemi-PD rats intrastriatally injected with BoNT-A exhibited reduced depression-like behavior compared with the respective vehicle-receiving hemi-PD animals. The significant effects of intrastriatally applied BoNT-A seen in the forced swim test are reminiscent of those found after various antidepressant drug therapies. Our data correspond with the efficacy of BoNT-A treatment of glabellar frown lines in treating patients with major depression and suggest that also intrastriatal injected BoNT-A may have some antidepressant-like effect on hemi-PD.

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“…Due to neuromotor disorders, BoNT has been reported to be effective in treating dystonia, gnashing of teeth, tremors, tics, myoclonus, restless legs syndrome, delayed dyskinesia, and a variety of symptoms associated with Parkinson's disease. In addition, the toxin has been developed as a potent muscle relaxant and active marginal drug for pote ntial applications of the central nervous system in the treatment of neurodegenerative disorders [46].…”

Section: Resultsmentioning

confidence: 99%

Epidemiological aspects of poisoning Infectious-toxic bacteria of botulism on food poisoning in Iran; A review study

Mirbehresi

Pirhadi

Shokri

et al. 2022

Egyptian Journal of Veterinary Sciences

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B OTULISM is a rare neuroparalytic syndrome, caused by a neurotoxin produced by bacteria of the genus Clostridium. Signs and symptoms of food botulism begin 12 to 36 hours after the toxin enters the bloodstream .Clostridium botulinum is one of the most common life-threatening agents worldwide, producing the botulinum neurotoxin (BoNT). Poisoning is caused by the consumption of a highly toxic exotoxin produced during the growth of microorganisms in food. The growth of Clostridium botulinum strains and their production of toxins in vacuum processed foods have received special attention. Symptoms of botulism may appear 12 to 72 hours after eating foods that contain toxins, such as canned tuna, local dairy products, and home-made or commercial foods. Symptoms of poisoning include nausea, vomiting, bruising, dizziness and headache, dry skin, sore throat, constipation, mild fever (or no fever), muscle paralysis, diplopia, and eventually respiratory problems and death. On the other hand, botulinum neurotoxin is used in medicine and psychiatry. BoNT is involved in the management and control of many diseases such as depression and Parkinson's, dermatitis such as psoriasis, as well as in the beauty and elimination of facial skin wrinkles.

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Botulinum Toxin in Movement Disorders: An Update

Cited by 76 publications

References 284 publications

Duration and onset of effect of incobotulinumtoxinA for the treatment of blepharospasm in botulinum toxin-naïve subjects

Duration and onset of effect of incobotulinumtoxinA for the treatment of blepharospasm in botulinum toxin-naïve subjects

Antidepressant-Like Properties of Intrastriatal Botulinum Neurotoxin-A Injection in a Unilateral 6-OHDA Rat Model of Parkinson’s Disease

Epidemiological aspects of poisoning Infectious-toxic bacteria of botulism on food poisoning in Iran; A review study

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