Cervical dystonia: ways to improve the effectiveness of botulinum therapy

Ivolgin, A. F.; Avseitseva, T.Y.

doi:10.17116/jnevro2020120061137

Cited by 2 publications

(4 citation statements)

References 22 publications

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“…Состояние пациентов и выраженность симптомов ЦД оценивали по шкале TWSTRS (оценка тяжести ЦД) во время лечения и в последний доступный период наблюдения. туры, медикаментозной терапии, хирургических вмешательств на мышцах шейного отдела, стереотаксической аблации, глубинной стимуляции головного мозга до инновационных малоинвазивных подходов, таких как применение фокусированного ультразвука под контролем МРТ (МР-ФУЗ) [6,7,[12][13][14][15][16][17]. Медикаментозное лечение пероральными формами препаратов (клоназепам, антихолинергические препараты, миорелаксанты и др.)…”

Section: материалы и методыunclassified

“…чаще всего малоэффективно и сопровождается значимыми побочными явлениями при попытке увеличения дозировки с целью достижения необходимого терапевтического эффекта [4,16]. Золотым стандартом лечения ЦД в настоящее время является использование ботулинического токсина типа А для уменьшения патологических движений и болевого синдрома [6,7]. Недостатками метода являются необходимость периодических инъекций каждые 3-4 мес, неодинаковая эффективность при различных клинических проявлениях ЦД, снижение эффективности и развитие рефрактерности у части пациентов [16,18].…”

Section: материалы и методыunclassified

“…Этиология ЦД весьма многообразна. Принято выделять врождённые (идиопатическая дистония) и приобретённые формы [5][6][7]. При идиопатической ЦД показана связь заболевания с мутациями в генетических локусах DYT2, DYT13, DYT23, DYT24, DYT25 и др.…”

Section: Introductionunclassified

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MRI-Guided Focused Ultrasound in Cervical Dystonia

Galimova,

Illarioshkin,

Buzaev

et al. 2024

Annals of Clinical and Experimental Neurology

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Introduction. MRI-guided focused ultrasound (MRgFUS) is approved for management of various movement disorders, primarily essential tremor and Parkinson’s disease (PD), with favorable long-term outcomes in numerous patients worldwide. However, few case studies describe the use of this modality for symptomatic treatment of dystonias that, as the third most common movement disorder, may be rather disabling. Objective: To improve outcomes in patients with cervical dystonia (CD) using MRgFUS. Materials and methods. We retrospectively analyzed 13 cases of various CD types managed with MRgFUS in single or multiple sessions. The mean age of the patients was 42 [39; 53] years. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to assess patients' statuses and severity of CD symptoms during therapy and the last available observation period. The targets included the pallidothalamic tract and the thalamic ventral oralis complex nucleus or their combination. Results. The mean follow-up period was 13.3 ± 3.4 months (July 2021 to April 2023). The mean CD severity sum score (TWSTRS score) was 22 [16; 25] before MRgFUS and 6 [4; 9] in the last observation. Therefore, we report 70.6% [55.6; 76.5] improvement (paired samples t-test p = 0.0025). Conclusion. Available data evidence that MRgFUS is efficient and sufficiently safe for symptomatic treatment in pharmacoresistant CD patients. A number of vital aspects of MRgFUS have to be specified in larger CD cohorts in the long-term follow-up.

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Section: материалы и методыunclassified

Section: Introductionunclassified

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MRI-Guided Focused Ultrasound in Cervical Dystonia

Galimova,

Illarioshkin,

Buzaev

et al. 2024

Annals of Clinical and Experimental Neurology

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“…К причинам неудовлетворенности относится недостаточный или непродолжительный эффект от инъекций. Таким образом, в 45% случаев не удается добиться полного избавления пациента от симптомов ЦД, что, прежде всего, связано со сложностью диагностического анализа сформированного мышечного паттерна ЦД и особенностями применения препаратов БоНТ [5][6][7].…”

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Novel approaches to the treatment of cervical dystonia. The concept of dual navigation control

Коваленко

Zalyalova

Ivolgin³

2021

RJTAO

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Сervical dystonia (CD) is the most common type of focal dystonia (up to 50% of all dystonia cases). Botulinum neurotoxin (BoNT) injections is the treatment choice for CD. However, the effectiveness and tolerability of botulinum therapy in CD depends on the correct choice of target muscles and the accuracy of the BoNT injection. The publication presents literature data and our own clinical experience regarding the use of navigation in BoNT injections in CD.According to the majority of authors, the use of navigation equipment, such as ultrasound (US) and electromyography (EMG), definitely increases the effectiveness of CD treatment and reduces the likelihood of adverse events. For the first time, an algorithm for the diagnosis and treatment of CD is proposed, based on the use of the method of «double- (EMG and US) guided navigation», a variant for determining the comparative activity of muscles by the intensity of the EMG signal and the design of an individual «passport» of the CD. The possibilities of analyzing the US of muscles, drawing up an accurate treatment regimen, targeted administration of BoNT, and using a non-injectable EMG electrode are shown. We present 4 clinical cases demonstrating the advantages of the double- (EMG+US) guided navigation method over the EMG-guided navigation for injection. The proposed algorithm for the diagnosis and treatment of CD makes it possible to increase the effectiveness of treatment, optimize the costs of BoNT and diagnostic equipment (injection EMG needle).

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Cervical dystonia: ways to improve the effectiveness of botulinum therapy

Cited by 2 publications

References 22 publications

MRI-Guided Focused Ultrasound in Cervical Dystonia

MRI-Guided Focused Ultrasound in Cervical Dystonia

Novel approaches to the treatment of cervical dystonia. The concept of dual navigation control

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