Related Experiment Video
Updated: Jan 17, 2026

Author Spotlight: Automated Deep Brain Stimulation for Parkinson's Disease - Exploring the Possibilities and Challenges of Home Monitoring
Published on: July 14, 2023
Anticholinergic Burden and Botulinum Toxin Needs after Deep Brain Stimulation in Adult and Pediatric Patients with
Marcela A Montiel1, Alessandro Magliozzi2,3, Wei Kang Lim4,5
1Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada., Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
Background:
Anticholinergic medications and botulinum neurotoxin injections are established treatments for dystonia, yet they carry potential side effects and practical challenges. Deep brain stimulation (DBS) is offered in case of poor response to these approaches.
Objectives:
To assess the need for anticholinergic medications and botulinum neurotoxin injections in adult and pediatric patients at two specialized Canadian centers before and after DBS over the past 10 years.
Methods:
58 patients were included analyzing data before, 6 and 12 months after DBS. Clinical assessment included the Toronto Western Spasmodic Torticollis Rating Scale and Fahn-Marsden Dystonia Rating Scale. Anticholinergic burden was determined by the Anticholinergic Drug Scale (ADS).
Results:
Severity of cervical dystonia and ADS scores reduction were statistically significant after DBS. Anticholinergic medication and Botulinum Neurotoxin injections were discontinued a year after surgery in 28.8% and 72.4% of the patients, respectively.
Conclusion:
Simplification of anti-dystonia treatments is another added benefit of DBS.
Related Concept Videos
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
The binding of dantrolene to the RYR1...
Depolarizing Blockers: Pharmocokinetics
Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal Muscle Relaxants: Adverse Effects
Unlike...
Indirect-Acting Cholinergic Agonists: Pharmacological Actions
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
Direct-Acting Cholinergic Agonists: Therapeutic Uses

