Special Issue "Treatment Applications of Botulinum Toxins in the Multidisciplinary and Integrated Management of Pain Syndromes"

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: 31 October 2021.

Special Issue Editors

Prof. Dr. Marialuisa Gandolfi
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Guest Editor
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
Prof. Dr. Marco Testa
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Guest Editor
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genova, Italy
Dr. Simone Battista
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Guest Editor
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genova, Italy

Special Issue Information

Dear Colleagues,

Botulinum neurotoxin (BoNT) treatment applications have been progressively expanded in the last decade to include a wide range of motor and non-motor disorders. Particularly relevant is the use of BoNT in the management of patients with chronic neuropathic, nociceptive and visceral pain conditions. In line with a bio-psycho-social care process, the management of pain conditions requires a multidisciplinary approach combining pharmacological and non-pharmacological interventions. Note that the literature suggests the importance of identifying interventions that could enhance the BoNT pharmacological effects especially in chronic musculoskeletal and neurological conditions such as primary headaches, myofascial pain syndrome and pain due to acquired central nervous system lesions. The proposal made here aims at collecting the best evidence on the effects of care models dedicated to implementing physical, rehabilitative and psychological approaches in rehabilitation that can express all the therapeutic potentials of an integrated multidisciplinary approach in which the effect of BoNT treatment is enriched. Multi- and single-centre randomized controlled trials, original reports, innovative and informative case studies or series, systematic reviews and meta-analyses in human populations are all welcome.

Prof. Dr. Marialuisa Gandolfi
Prof. Dr. Marco Testa
Dr. Simone Battista
Guest Editors

Manuscript Submission Information

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Keywords

  • physical therapy modalities
  • interdisciplinary studies
  • pain
  • spasticity
  • headache disorders
  • myofascial pain syndromes
  • musculoskeletal pain
  • visceral pain

Published Papers (2 papers)

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Article
Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia
Toxins 2021, 13(9), 605; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13090605 - 29 Aug 2021
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Abstract
The differences in analgesic effects of botulinum toxin type A were compared in 28 patients with trigeminal neuralgia, 53 patients with myofascial temporomandibular disorders, and 89 patients with the jaw closing oromandibular dystonia. The patients were treated by injection of botulinum toxin type [...] Read more.
The differences in analgesic effects of botulinum toxin type A were compared in 28 patients with trigeminal neuralgia, 53 patients with myofascial temporomandibular disorders, and 89 patients with the jaw closing oromandibular dystonia. The patients were treated by injection of botulinum toxin type A into the masseter, temporalis, medial pterygoid, and other muscles based on the symptoms of each patient. The pain severity was evaluated using the visual analog scale, pain frequency, and pain scale of the oromandibular dystonia rating scale. Botulinum toxin injection was performed 1068 times in all patients without significant adverse effects. The visual analog, pain frequency, and pain scales at baseline were reduced (p < 0.001) after two, four, eight, and 12 weeks after the first botulinum toxin therapy and at the endpoint. The effects differed significantly (p < 0.001) among the groups (repeated-measures analysis of variance). The mean improvement (0%, no effect; 100%, complete recovery) at the endpoint was 86.8% for trigeminal neuralgia, 80.8% for myofascial pain, and 75.4% for oromandibular dystonia. Injection of the botulinum toxin can be a highly effective and safe method to treat trigeminal neuralgia, myofascial pain, and oromandibular dystonia. Full article
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Systematic Review
The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis
Toxins 2021, 13(9), 640; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13090640 - 10 Sep 2021
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Abstract
Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a [...] Read more.
Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a multimodal approach. Hence, Medline via PubMed, EMBASE, and the Cochrane Library-CENTRAL were searched until November 2020 for randomised controlled trials (RCTs) that investigated the use of BoNT-A as an adjunctive therapy for chronic musculoskeletal pain. The risk of bias (RoB) and the overall quality of the studies were assessed through RoB 2.0 and the GRADE approach, respectively. Meta-analysis was conducted to analyse the pooled results of the six included RCTs. Four were at a low RoB, while two were at a high RoB. The meta-analysis showed that BoNT-A as an adjunctive therapy did not significantly decrease pain compared to the sole use of traditional treatment (SDM −0.89; 95% CI −1.91; 0.12; p = 0.08). Caution should be used when interpreting such results, since the studies displayed very high heterogeneity (I = 94%, p < 0.001). The overall certainty of the evidence was very low. The data retrieved from this systematic review do not support the use of BoNT-A as an adjunctive therapy in treating chronic musculoskeletal pain. Full article
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