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Deep Brain Stimulation with Simultaneous fMRI in Rodents
Published on: February 15, 2014
14.6K
IncobotulinumtoxinA and Deep Brain Stimulation.
1From the Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Summary
Botulinum toxin-A (BoNT-A) injections after deep brain stimulation (DBS) may be beneficial for cervical dystonia patients, potentially reducing dosage and extending treatment benefits. Further research is needed to confirm these findings.
Area of Science:
- Neurology
- Neurosurgery
- Pharmacology
Background:
- Current guidelines suggest Botulinum toxin-A (BoNT-A) use post-deep brain stimulation (DBS).
- The combined efficacy of BoNT-A and DBS remains uncertain for neurological movement disorders.
- IncobotulinumtoxinA and OnabotulinumtoxinA are commonly used BoNT-A formulations.
Purpose of the Study:
- To evaluate the effectiveness of BoNT-A, specifically IncobotulinumtoxinA, when administered before versus after DBS in patients with Parkinson's disease and dystonia.
- To compare treatment outcomes and dosage requirements for IncobotulinumtoxinA in relation to DBS timing.
Main Methods:
- A retrospective chart review was conducted on patients with Parkinson's disease (n=17) and dystonia (n=7).
- Data from 302 IncobotulinumtoxinA injections, administered either before or after DBS, were analyzed.
- Treatment outcomes, including dosage and duration of benefit, were compared based on the timing of BoNT-A relative to DBS.
Main Results:
- Patients with cervical dystonia receiving IncobotulinumtoxinA after DBS required significantly lower doses (192.4 ± 131.4 units) compared to those treated before DBS (290.7 ± 124.0 units; p = 0.005).
- The duration of therapeutic benefit was significantly longer for cervical dystonia patients treated with IncobotulinumtoxinA after DBS (8.4 ± 3.6 weeks) compared to those treated before DBS (4.0 ± 3.4 weeks; p = 0.003).
- No significant differences in treatment outcomes were observed when comparing IncobotulinumtoxinA and OnabotulinumtoxinA in patients who received both after DBS.
Conclusions:
- The findings suggest that using Botulinum toxin-A after deep brain stimulation is a viable and potentially more effective strategy for managing cervical dystonia.
- Lower doses and longer duration of benefit were observed when BoNT-A was administered post-DBS in cervical dystonia patients.
- Prospective studies are warranted to validate these retrospective findings and further elucidate the optimal use of BoNT-A in conjunction with DBS.
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