| Title |
Responsiveness to botulinum toxin type A in muscles of complex regional pain patients with tonic dystonia
|
|---|---|
| Published in |
Journal of Neural Transmission, February 2014
|
| DOI | 10.1007/s00702-014-1172-8 |
| Pubmed ID | |
| Authors |
Johanna C. M. Schilder, J. Gert van Dijk, Dirk Dressler, Johannes H. T. M. Koelman, Johan Marinus, Jacobus J. van Hilten |
| Abstract |
Tonic dystonia of the limbs in complex regional pain syndrome (CRPS) is associated with considerable disability. Treatment options are scarce. Botulinum toxin (BoNT) is sometimes used, but the effect is often said to be disappointing. However, this notion stems from case reports and clinicians' opinions but has never been formally studied. We therefore investigated responsiveness to BoNT in CRPS patients with tonic dystonia. We injected the extensor digitorum brevis (EDB) muscle with BoNT-A in 17 patients with CRPS and tonic dystonia to compare the response between affected and unaffected legs. We also investigated the right legs of 17 healthy controls. Responsiveness was defined as a decrease of the amplitude of the compound muscle action potential (CMAP) of >20 % from baseline 2 weeks after BoNT-A injection. We controlled for a temperature effect on BoNT efficacy by measuring skin temperature hourly directly above the EDB muscle in the first 2 weeks. CMAP amplitude decreased >20 % after injection on the affected side in 16 of 17 CRPS patients, similar to the response in unaffected legs (12/13) or legs of controls (17/17). The degree of CMAP reduction was significantly smaller in patients than in controls (56.0 ± 22.3 vs. 70.6 ± 14.6 %; p = 0.031). This may be due to a lower physical activity level and a greater difficulty to localize the EDB muscle properly in affected legs. The decrease in CMAP amplitude was not related to skin temperature. Contrary to the prevailing opinion, BoNT-A has a normal, although perhaps slightly lower efficacy in CRPS patients with dystonia. |
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 3% |
| Unknown | 39 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 5 | 13% |
| Student > Doctoral Student | 5 | 13% |
| Student > Postgraduate | 5 | 13% |
| Student > Bachelor | 4 | 10% |
| Researcher | 4 | 10% |
| Other | 9 | 23% |
| Unknown | 8 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 43% |
| Agricultural and Biological Sciences | 3 | 8% |
| Neuroscience | 3 | 8% |
| Chemistry | 2 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Other | 4 | 10% |
| Unknown | 10 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 March 2014.
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#18,369,403
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Outputs from Journal of Neural Transmission
#1,419
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#251,061
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Outputs of similar age from Journal of Neural Transmission
#14
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