Do Diagnostic Nerve Blocks Affect the Starting Dose of Botulinum Neurotoxin Type A for Spasticity? A Case-Control Study

IF 3.9 3区医学 Q2 FOOD SCIENCE & TECHNOLOGY

Toxins Pub Date : 2024-09-06 DOI:10.3390/toxins16090388

Mirko Filippetti, Stefano Tamburin, Rita Di Censo, Roberto Aldegheri, Elisa Mantovani, Stefania Spina, Marco Battaglia, Alessio Baricich, Andrea Santamato, Nicola Smania, Alessandro Picelli

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引用次数: 0

Abstract

One of the aims of diagnostic nerve blocks is to identify the overactive muscles that lead to a specific spasticity pattern. However, to date, there is no evidence on how nerve blocks may affect botulinum neurotoxin-A (BoNT-A) dose in patients with spasticity. This case-control study aims to assess the role of diagnostic nerve block in defining BoNT-A starting dose at first treatment. Patients with upper and lower limb spasticity treated for the first time with BoNT-A were retrospectively divided into two groups: Group 1 (n = 43) was evaluated with clinical assessment and diagnostic nerve block; Group 2 (n = 56) underwent clinical assessment only. Group 1 was injected with higher BoNT-A doses in some muscles (i.e., flexor digitorum profundus, soleus), and received a higher BoNT-A cumulative dose with a larger number of injected muscles for some spasticity patterns (i.e., “clenched fist”, “flexed fingers”, “adducted thigh”). Diagnostic nerve block may help the clinician to optimize and personalize the BoNT-A dose since the first BoNT-A treatment.

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诊断性神经阻滞会影响治疗痉挛的 A 型肉毒杆菌神经毒素的起始剂量吗？病例对照研究

诊断性神经阻滞的目的之一是确定导致特定痉挛模式的过度活跃肌肉。然而，迄今为止还没有证据表明神经阻滞会如何影响痉挛患者的肉毒杆菌神经毒素-A（BoNT-A）剂量。本病例对照研究旨在评估诊断性神经阻滞在确定首次治疗的 BoNT-A 起始剂量方面的作用。研究人员回顾性地将首次接受 BoNT-A 治疗的上下肢痉挛患者分为两组：第一组（43 人）接受临床评估和诊断性神经阻滞；第二组（56 人）仅接受临床评估。第 1 组在某些肌肉（如屈指肌、比目鱼肌）注射了较高剂量的 BoNT-A，在某些痉挛模式（如 "握拳"、"屈指"、"大腿内收"）中注射了较高剂量的 BoNT-A 累积剂量和较多的注射肌肉。诊断性神经阻滞可帮助临床医生优化和个性化首次 BoNT-A 治疗后的 BoNT-A 剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Toxins TOXICOLOGY-

CiteScore

7.50

自引率

16.70%

发文量

765

审稿时长

16.24 days

期刊介绍： Toxins (ISSN 2072-6651) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to toxins and toxinology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.