Quality of Life After Botulinum Toxin Injection in Patients With Adductor Spasmodic Dysphonia; a Systematic Review and Meta-analysis

Faham, Maryam; Ahmadi, Akram; Silverman, Erin; Harouni, Gholamreza Ghaedamini; Dabirmoghaddam, Payman

doi:10.1016/j.jvoice.2019.07.025

Cited by 18 publications

(19 citation statements)

References 60 publications

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“…Previous studies have also reported that VHI is commonly used to assess the treatment effect for SD. 30 , 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

“…Change values of number of aberrant morae, (S) in GRBAS, VHI and VAS were greater in subjects with AEs than those without AEs have also reported that VHI is commonly used to assess the treatment effect for SD. [30][31][32] In younger patients or those with longer disease duration, the therapeutic effect tended to be greater. This result is seemingly contradictory, as younger patients likely have a shorter disease duration.…”

Section: Discussionmentioning

confidence: 99%

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Post‐treatment clinical course following botulinum toxin injection therapy for adductor spasmodic dysphonia: Analysis of data from a placebo‐controlled, randomized, double‐blinded clinical trial in Japan

Hirose

Asano

Sakaguchi

et al. 2021

Laryngoscope Investig Oto

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Objective: Botulinum toxin (BT) therapy is a first-line treatment for spasmodic dysphonia (SD). However, a detailed chronological course and clinical factors that affect the therapeutic effect have been vague. In this study, we analyzed the data from our placebo-controlled, randomized, double-blinded parallel-group comparison/ open-label clinical trial of BT (Botox) to clarify these.Methods: A total of 22 patients with abductor SD (ADSD) were enrolled. The female-to-male ratio was 20:2 with a mean age of 40.0 ± 10.3 years and a median duration of symptoms of 7.5 years. The therapeutic effect was evaluated based on the change in the number of aberrant morae (phonemes), GRBAS scale, Voice Handicap Index (VHI), and Visual Analogue Scale (VAS). Results:The change in the number of aberrant morae peaked at 2 weeks and lasted for 12 weeks in the BT group with significance (P < .01) compared to the placebo group. Objective improvement (number of aberrant morae and [S] element in GRBAS) preceded subjective improvement (VHI and VAS). The change in number of aberrant morae and VHI showed a significant correlation (P < .01). The changes in the number of aberrant morae, VHI, and VAS in younger subjects were greater than in older subjects. Patients who presented with post-treatment breathy hoarseness or dysphagia showed better therapeutic effects.Conclusions: BT therapy was effective for ADSD based on both objective and subjective assessments. Improvements in subjective parameters were delayed compared to objective measures due to post-treatment breathy hoarseness. However, this adverse event was believed to reflect the treatment effect.

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“…Previous studies have also reported that VHI is commonly used to assess the treatment effect for SD. 30 , 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post‐treatment clinical course following botulinum toxin injection therapy for adductor spasmodic dysphonia: Analysis of data from a placebo‐controlled, randomized, double‐blinded clinical trial in Japan

Hirose

Asano

Sakaguchi

et al. 2021

Laryngoscope Investig Oto

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Section: Contribución De Los Autoresunclassified

“…Si bien a la fecha no existe método curativo efectivo, la inyección con toxina botulínica es el tratamiento más usado en pacientes con disfonía espasmódica, teniendo un efecto estimado de tres a cuatro meses [10], aunque podría extenderse hasta seis [11]. Existen varios y validados instrumentos para evaluar la respuesta a la terapia que demuestran reducciones significativas del impacto de la enfermedad, aunque sin lograr normalizar el puntaje [10]. Entre estos cuestionarios se encuentra el índice de discapacidad vocal (VHI, Voice Handicap Index por sus siglas en inglés) y su versión abreviada VHI-10, que ha demostrado tener similar potencia para cuantificar el impacto percibido en la propia función vocal, capacidad física en relación con ella y en las emociones provocadas por la disfonía [12,13].…”

Section: Contribución De Los Autoresunclassified

Impacto en la calidad de vida del tratamiento de disfonía espasmódica aductora con toxina botulínica A

Oliva

Acevedo

Arenas

et al. 2021

Rev. Investig. Innov. Cienc. Salud

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Introducción. La distonía laríngea o disfonía espasmódica se caracteriza por contracciones involuntarias de los músculos laríngeos internos que se desencadenan al hablar, siendo la forma aductora la más frecuente. La inyección de toxina botulínica es el manejo de elección. Para evaluar la respuesta a la terapia existen varios instrumentos validados, uno de ellos es el cuestionario Voice Handicap Index-10 (VHI-10). El objetivo de este estudio es caracterizar a los pacientes con disfonía espasmódica aductora y evaluar el impacto de la toxina en su calidad de vida. Método. Éste se centró en un estudio retrospectivo descriptivo en pacientes adultos con diagnóstico de disfonía espasmódica aductora tratados con toxina botulínica A, en el Hospital Clínico Universidad de Chile (HCUC), en el periodo comprendido entre 2013 y 2021. El mismo permitió la obtención de los datos epidemiológicos de los pacientes, a quienes se les solicitó responder la encuesta VHI-10 previo y posterior a un mes de cada inyección de la toxina. Resultados. Se incluyeron 55 pacientes (218 procedimientos). La dosis promedio utilizada fue de 9,18 UI con un intervalo promedio de 7,4 meses. El puntaje VHI-10 promedio en la evaluación inicial fue de 29,4 y posinfiltración de 14,96, siendo esta diferencia significativa (p < 0,000001). En nuestra serie casi un tercio tiene asociada alguna patología neurológica, y se reportó un 3,67% de complicaciones leves y transitorias. Conclusión. La disfonía espasmódica aductora tiene un gran impacto en la calidad de vida de los pacientes, que se reduce significativamente mediante la inyección de toxina botulínica A, procedimiento que ha demostrado ser seguro y eficaz.

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“…Laryngeal dystonia (LD) is isolated focal task-specific dystonia characterized by involuntary spasms in the laryngeal muscles that occur predominantly during speech production. LD negatively affects the quality of life as patients are limited in their daily and professional activities due to inability to communicate, which leads to lower socio-economic status, poor selfperception, psychiatric comorbidities, and suicidal behaviors 1,2 . Despite its chronic, debilitating impact, LD pathophysiology is unclear, and, consequently, the therapeutic options remain limited.…”

Section: Introductionmentioning

confidence: 99%

Short- and Long-term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia

O'Flynn

Simonyan

2022

Neurology

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Background and Objectives:Laryngeal dystonia (LD) is isolated task-specific focal dystonia selectively impairing speech production. The first choice of LD treatment is botulinum neurotoxin (BoNT) injections into the affected laryngeal muscles. However, whether BoNT has a lasting therapeutic effect on disorder pathophysiology is unknown. We investigated short- and long-term effects of BoNT treatment on brain function in LD patients.Methods:A total of 161 subjects participated in the functional MRI study. Statistical analyses examined central BoNT effects in LD patients who were stratified based on the effectiveness and duration of treatment.Results:LD patients who were treated and benefited from BoNT injections had reduced activity in the left precuneus compared to BoNT-naïve and treatment non-benefiting patients. Additionally, BoNT-treated patients with adductor LD had decreased activity in the right thalamus, whereas BoNT-treated abductor LD patients had reduced activity in the left inferior frontal cortex. No statistically significant differences in brain activity were found between patients with shorter (1-5 years) and longer (13-28 years) treatment durations. However, patients with intermediate treatment duration of 6 to 12 years showed reduced activity in the right cerebellum compared to patients with both shorter and longer treatment durations and reduced activity in the right prefrontal cortex compared to patients with shorter treatment duration.Discussion:Our findings suggest that the left precuneus is the site of short-term BoNT central action in LD patients, whereas the prefrontal-cerebellar axis is engaged in the BoNT response in patients with intermediate treatment duration of 6-12 years. Involvement of these structures points to indirect action of BoNT treatment on the dystonic sensorimotor network via modulation of speech motor sequence planning and coordination.

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Quality of Life After Botulinum Toxin Injection in Patients With Adductor Spasmodic Dysphonia; a Systematic Review and Meta-analysis

Cited by 18 publications

References 60 publications

Post‐treatment clinical course following botulinum toxin injection therapy for adductor spasmodic dysphonia: Analysis of data from a placebo‐controlled, randomized, double‐blinded clinical trial in Japan

Post‐treatment clinical course following botulinum toxin injection therapy for adductor spasmodic dysphonia: Analysis of data from a placebo‐controlled, randomized, double‐blinded clinical trial in Japan

Impacto en la calidad de vida del tratamiento de disfonía espasmódica aductora con toxina botulínica A

Short- and Long-term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia

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