Nonlinear Changes in Botulinum Toxin Treatment of Task-Specific Dystonia during Long-Term Treatment
Nonlinear Changes in Botulinum Toxin Treatment of Task-Specific Dystonia during Long-Term Treatment
Blog Article
Botulinum toxin (BoTX) is the standard treatment for task-specific dystonias (TSDs) such as musician’s dystonia (MD).Our aim was to assess the long-term changes in BoTX treatment in a Ornaments highly homogeneous and, to our knowledge, largest group of MD patients with respect to the following parameters: (1) absolute and (2) relative BoTX dosage, (3) number of treated muscles, and (4) inter-injection interval.We retrospectively assessed a treatment period of 20 years in 233 patients, who had received a cumulative dose of 68,540 MU of BoTX in 1819 treatment sessions, performed by two neurologists.Nonlinear correlation was used to analyze changes in the parameters over the course of repeated treatments.Post-hoc we applied a median-split to classify two subgroups (high-BoTX, low-BoTX) depending on the total amount of BoTX needed during treatment.
Across all patients, we found a decrease of dosage for the first approximately 25 treatments with an increase afterwards.The number of muscles SILICEA TWIN PK and inter-injection intervals increased with time with a discrete decrease of inter-injection intervals after about 35 treatments.Subgroup differences were observed in the amount of BoTX and inter-injection intervals, with continuously increasing inter-injection intervals and decreasing BoTX dosage in the low-BTX group.Both groups showed a continuously increasing number of injected muscles.In summary, we found nonlinear changes of BoTX dosage and inter-injection intervals and a continuously increasing number of injected muscles with treatment duration in TSD-patients.
Furthermore, we, for the first time, identified two subgroups with distinct differences.Increasing inter-injection intervals and decreasing BoTX dosages in the low-BoTX group indicated improvement of symptoms with continued treatment.Continually increasing BoTX dosages with unchanged inter-injection intervals in the high-BoTX group indicated deterioration.