Efficacy of botulinum neurotoxin-A in the treatment of neuropsychiatric symptoms in patients with Parkinson's disease: an open-label randomized controlled study.

Objectives: Parkinson's disease (PD) often presents with neuropsychiatric symptoms that worsen quality of life. The aim of this study was to evaluate the effectiveness of Botulinum neurotoxin-A (BTX-A) in managing neuropsychiatric manifestations in PD patients.

Methods: Neuropsychiatric status was assessed in 185 PD patients using the Cornell Medical Index (CMI). Ninety-four patients exhibiting neuropsychiatric symptoms were randomly assigned to two groups: BTX-A (n=47, local injections) and citalopram (n=47, 10-40 mg/day). Outcomes were compared at baseline and 8 weeks post-treatment.

Results: The authors findings revealed a significant reduction in somatization, tension, anxiety, depression, sensitivity, and overall scores in the BTX-A group at the eight-week follow-up (p < 0.05 for all). Notably, patients in the BTX-A group exhibited similar levels of somatization, depression, anxiety, maladjustment, sensitivity, anger, and overall scores compared to the citalopram group (p > 0.05 for all). Both groups reported comparable percentages of improvement in neuropsychiatric symptoms (75.6% vs. 82.6%, p = 0.57).

Conclusions: This study demonstrates the potential of BTX-A in alleviating tension, anxiety, depression, sensitivity, and other neuropsychiatric symptoms in PD patients. Importantly, BTX-A's efficacy was comparable to that of citalopram, suggesting its potential as a viable therapeutic option for managing neuropsychiatric manifestations in PD.