Long-Term Effects of Different Number of Botulinum Toxin Injections Into the Gastrocnemius Muscle on Function and Muscle Morphology in Children With Cerebral Palsy

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2024-10-22 DOI:10.1016/j.pediatrneurol.2024.10.013

Kamile Uzun Akkaya PhD , Habip Eser Akkaya MD , Sabiha Bezgin PhD , Pelin Atalan Efkere PhD , Tuzun Firat PhD , Cemil Yildiz MD , Bulent Elbasan PhD

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引用次数: 0

Abstract

Background

Botulinum toxin (BoNT) injections are used to reduce spasticity, and sometimes repeated injections are required. The aim of this study is to investigate the effects of the number of BoNT injections into the gastrocnemius muscle on function, muscle morphology, muscle stiffness, and muscle vascularization in children with cerebral palsy (CP).

Methods

The study included 22 children with spastic-type CP aged five to 13 years who had previously received one, two, or three BoNT injections into the gastrocnemius muscle. A total of 29 gastrocnemius muscles were evaluated. Gastrocnemius muscle morphology was examined by ultrasonography, muscle stiffness by shear wave ultrasound elastography, and muscle vascularization by superb microvascular imaging. The functional status of the children was evaluated by the Gross Motor Function Measurement, the Timed-Up-and-Go Test, the Squat Test, the Vertical Jumping Test, and the Sit-and-Reach Test.

Results

In the motor functions and muscle morphology values were similar in all three groups (P > 0.05). Muscle stiffness values were higher (P = 0.035) and vascularization values were lower (P = 0.03) in the group that received three injections compared with the groups that received one injection. There was a moderate positive correlation of the number of BoNTs with muscle stiffness (P < 0.05, r = 0.454) and a moderate negative correlation with muscle vascularization (P < 0.05, r = −0.497).

Conclusions

Repeated BoNT applications have no effect on motor functions and muscle morphology in children with CP, whereas BoNT injections administered three times increase muscle stiffness and decrease vascularization.

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不同剂量的肉毒杆菌毒素注射对脑瘫儿童腓肠肌功能和肌肉形态的长期影响

背景：肉毒杆菌毒素（BoNT）注射用于减轻痉挛，有时需要重复注射。本研究旨在调查腓肠肌注射 BoNT 的次数对脑瘫（CP）儿童的功能、肌肉形态、肌肉僵硬度和肌肉血管化的影响：研究对象包括 22 名年龄在 5 至 13 岁之间的痉挛型 CP 患儿，这些患儿曾接受过一次、两次或三次腓肠肌 BoNT 注射。共评估了 29 块腓肠肌。超声波检查了腓肠肌的形态，剪切波超声弹性成像检查了肌肉的硬度，超级微血管成像检查了肌肉的血管化。通过粗大运动功能测量、定时起立行走测试、深蹲测试、垂直跳跃测试和坐立行走测试评估了儿童的功能状况：三组儿童的运动功能和肌肉形态值相似（P>0.05）。与接受一次注射的组别相比，接受三次注射的组别肌肉僵硬度值更高（P = 0.035），血管化值更低（P = 0.03）。BoNTs 的数量与肌肉僵硬度呈中度正相关（P 结论：BoNTs 的数量与肌肉僵硬度呈中度正相关：重复注射 BoNT 对脊髓灰质炎患儿的运动功能和肌肉形态没有影响，而注射三次 BoNT 会增加肌肉僵硬度并降低血管生成。

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

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.