探讨注射对宫 dystonia 的临床和假定的效果之间的相互作用:一个试点研究
Harald Hefter1, Sara Samadzadeh1,2,3,4
1Department of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Toxins
|October 27, 2023
概括
用A型肉毒神经毒素 (BoNT/A) 治疗的宫性 dystonia (CD) 患者感觉到显著的益处. 患者认为BoNT/A疗法可以防止疾病的严重恶化,将经历的改善与预防进展相结合,从而获得整体治疗价值.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 宫性 dystonia (CD) 通常通过反复的肌内注射甲型肉毒神经毒素 (BoNT/A) 来管理.
- 启动BoNT治疗可以防止在CD患者中观察疾病的自然过程.
- 这项研究调查了没有BoNT治疗的假定疾病进展情况,并将其与经验中的好处进行比较.
研究的目的:
- 评估没有BoNT/A治疗的宫性 dystonia 严重性的感知自然过程.
- 为了比较BoNT/A治疗的经验好处与CD的假定恶化.
- 探索假定疾病进展和患者/治疗因素之间的相关性.
主要方法:
- 长期接受BoNT/A治疗的27名CD患者评估了其余严重程度 (RS-%) 并绘制了疾病过程图表.
- 患者估计了假定恶化 (IS-%) 并绘制了没有BoNT/A的假定疾病进程 (CoDI图).
- 经验和假定的变化与人口统计和治疗数据进行了比较和相关联,包括TSUI得分和ADOSE.
主要成果:
- 没有患者预计没有BoNT/A治疗的改善.
- 平均假定恶化 (IS-%) 约为50%,与经验中的好处 (100-(RS-%) 无关.
- 假定恶化 (IS-%) 与实际的TSUI得分和ADOSE显著相关.
结论:
- 癌症患者认为,如果没有BoNT/A治疗,他们的病情会明显恶化.
- 对BoNT/A治疗的总益处被认为是经历改善和预防疾病进展的结合.
- 患者对预防恶化的期望是BoNT/A治疗CD感知价值的关键组成部分.
相关概念视频
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
685
Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...
685
Skeletal Muscle Relaxants: Adverse Effects
377
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
377
Skeletal Muscle Relaxants: Therapeutic Uses
493
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
493
Depolarizing Blockers: Pharmocokinetics
330
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
330
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
432
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
432
Indirect-Acting Cholinergic Agonists: Pharmacological Actions
698
Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
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...
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...
698


