Effective Management of Upper Limb Parkinsonian Tremor by IncobotulinumtoxinA Injections Using Sensor-based Biomechanical Patterns

Botulinum Toxin for the Treatment of Hand Tremor

“…To our knowledge, this is the longest duration of follow-up data reported regarding the use of BoNT for hand tremor, although we previously reported our long-term experience with BoNT in the treatment of dystonia over a period of more than 20 years [19]. The mean age of our patient population and the male predominance is similar to those reported in recently published studies of BoNT in the treatment of tremor [20][21][22][23][24][25]. There was a relatively long period of time between onset of symptoms and first injection (mean 23.2 years, up to 75 years).…”

“…Several well-designed studies have evaluated the use of kinematic tremor analysis coupled with EMG-guidance in the application of BoNT [20,21,23,[30][31][32]. Kinematic analysis allows the clinician to objectively characterize tremor at the wrist, elbow and shoulder joint, thereby creating an individual "tremor profile" which can be re-assessed at future visits thus allowing for optimization of the injection pattern.…”

Botulinum Toxin for the Treatment of Hand Tremor

“…To our knowledge, this is the longest duration of follow-up data reported regarding the use of BoNT for hand tremor, although we previously reported our long-term experience with BoNT in the treatment of dystonia over a period of more than 20 years [19]. The mean age of our patient population and the male predominance is similar to those reported in recently published studies of BoNT in the treatment of tremor [20][21][22][23][24][25]. There was a relatively long period of time between onset of symptoms and first injection (mean 23.2 years, up to 75 years).…”

“…Several well-designed studies have evaluated the use of kinematic tremor analysis coupled with EMG-guidance in the application of BoNT [20,21,23,[30][31][32]. Kinematic analysis allows the clinician to objectively characterize tremor at the wrist, elbow and shoulder joint, thereby creating an individual "tremor profile" which can be re-assessed at future visits thus allowing for optimization of the injection pattern.…”

Botulinum Toxin in Movement Disorders: An Update

“…Fixed doses, limited muscles being injected, and complicating weakness postinjections initially made BoNT use for tremors unsatisfactory [205]. In 2015, a series of 28 PD patients with tremors underwent muscle selection of incobotulinumtoxinA and patients improved at 16 weeks [209]. In an open-label prospective trial, 31 ET patients received 3 cycles of BoNTA based on kinematic analysis guided muscle selection and dose administered [206]; it showed that BoNTA reduced tremor by 47.7% at 6 weeks and the improvement lasted 18–30 weeks.…”

Personalized Bilateral Upper Limb Essential Tremor Therapy with Botulinum Toxin Using Kinematics

“…A study limitation of our previously published tremor-toxin studies allowed the injector to adjust dosing parameters [3,4,13]. In this study, a blinded-injector approach was utilized as initial BoNT-A injection parameters were entirely based on our computer-assisted, kinematic tremor analysis, and optimization of BoNT-A injections was conducted using kinematics and any presence of weakness perceived by each participant.…”

Botulinum Toxin for the Treatment of Hand Tremor

“…To our knowledge, this is the longest duration of follow-up data reported regarding the use of BoNT for hand tremor, although we previously reported our long-term experience with BoNT in the treatment of dystonia over a period of more than 20 years [19]. The mean age of our patient population and the male predominance is similar to those reported in recently published studies of BoNT in the treatment of tremor [20][21][22][23][24][25]. There was a relatively long period of time between onset of symptoms and first injection (mean 23.2 years, up to 75 years).…”

“…Several well-designed studies have evaluated the use of kinematic tremor analysis coupled with EMG-guidance in the application of BoNT [20,21,23,[30][31][32]. Kinematic analysis allows the clinician to objectively characterize tremor at the wrist, elbow and shoulder joint, thereby creating an individual "tremor profile" which can be re-assessed at future visits thus allowing for optimization of the injection pattern.…”

Botulinum Toxin in Movement Disorders: An Update

“…Fixed doses, limited muscles being injected, and complicating weakness postinjections initially made BoNT use for tremors unsatisfactory [205]. In 2015, a series of 28 PD patients with tremors underwent muscle selection of incobotulinumtoxinA and patients improved at 16 weeks [209]. In an open-label prospective trial, 31 ET patients received 3 cycles of BoNTA based on kinematic analysis guided muscle selection and dose administered [206]; it showed that BoNTA reduced tremor by 47.7% at 6 weeks and the improvement lasted 18–30 weeks.…”

Personalized Bilateral Upper Limb Essential Tremor Therapy with Botulinum Toxin Using Kinematics

“…A study limitation of our previously published tremor-toxin studies allowed the injector to adjust dosing parameters [3,4,13]. In this study, a blinded-injector approach was utilized as initial BoNT-A injection parameters were entirely based on our computer-assisted, kinematic tremor analysis, and optimization of BoNT-A injections was conducted using kinematics and any presence of weakness perceived by each participant.…”

Botulinum Toxin for the Treatment of Hand Tremor

“…To our knowledge, this is the longest duration of follow-up data reported regarding the use of BoNT for hand tremor, although we previously reported our long-term experience with BoNT in the treatment of dystonia over a period of more than 20 years [19]. The mean age of our patient population and the male predominance is similar to those reported in recently published studies of BoNT in the treatment of tremor [20][21][22][23][24][25]. There was a relatively long period of time between onset of symptoms and first injection (mean 23.2 years, up to 75 years).…”

“…Several well-designed studies have evaluated the use of kinematic tremor analysis coupled with EMG-guidance in the application of BoNT [20,21,23,[30][31][32]. Kinematic analysis allows the clinician to objectively characterize tremor at the wrist, elbow and shoulder joint, thereby creating an individual "tremor profile" which can be re-assessed at future visits thus allowing for optimization of the injection pattern.…”

Botulinum Toxin in Movement Disorders: An Update

“…Fixed doses, limited muscles being injected, and complicating weakness postinjections initially made BoNT use for tremors unsatisfactory [205]. In 2015, a series of 28 PD patients with tremors underwent muscle selection of incobotulinumtoxinA and patients improved at 16 weeks [209]. In an open-label prospective trial, 31 ET patients received 3 cycles of BoNTA based on kinematic analysis guided muscle selection and dose administered [206]; it showed that BoNTA reduced tremor by 47.7% at 6 weeks and the improvement lasted 18–30 weeks.…”

Personalized Bilateral Upper Limb Essential Tremor Therapy with Botulinum Toxin Using Kinematics

“…A study limitation of our previously published tremor-toxin studies allowed the injector to adjust dosing parameters [3,4,13]. In this study, a blinded-injector approach was utilized as initial BoNT-A injection parameters were entirely based on our computer-assisted, kinematic tremor analysis, and optimization of BoNT-A injections was conducted using kinematics and any presence of weakness perceived by each participant.…”