Evaluation of the Efficacy of Botulinum Neurotoxins

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

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 1988

Special Issue Editor


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Guest Editor
Fondazione Don Carlo Gnocchi Onlus: Milano, Lombardia, Italy
Interests: neurological diseases; such as stroke; traumatic brain injury; Parkinson’s disease; dystonia and peripheral neuropathy; clinical neurophysiology; psychometrics; human movement

Special Issue Information

Dear Colleagues, 

A growing body of evidence shows that botulinum neurotoxins (BNTs) are effective in a wide range of clinical conditions, such as blepharospasm and cervical dystonia. In these diseases, BNTs can even be the first line of therapy.

However, systematic reviews and meta-analyses have also showed some areas of uncertainty when it comes to BNTs efficacy. These aggregate studies have pointed out the lack of consistent outcome measures between the different clinical trials. Moreover, concerns can be raised about some of the outcome measures currently available. 

Measurement is a crucial step in the process of efficacy evaluation, and the demonstration of effectiveness implicitly comes through the demonstration of the improvement of variables that are valuable for patients, physicians and other stakeholders.

This Special Issue of Toxins, methodological in nature, addresses the evaluation of the efficacy of BNTs from a measurement perspective.

Scholars are encouraged to submit manuscripts reporting new questionnaires, clinical scales and instrumental measures (e.g., from movement analysis, echography, clinical neurophysiology or urodynamic studies) that are important in the BNTs clinic.

Studies evaluating existing outcome measures by means of modern psychometric techniques (such as the Rasch analysis and other techniques from the item response theory) are also of great interest.

Papers describing new outcome measures, whether they be questionnaires or instrumental measures, should be focused on validity and responsiveness, which should be evaluated with respect to anchors of real importance for patients treated with BTNs and their clinicians. For newly developed questionnaires and scales, priority will be given to those measures developed with modern psychometrics.

The ultimate goal of this Special Issue is to provide scholars and clinicians with sound measures to increase the chance of reaching the right conclusion about BNTs efficacy.

Dr. Antonio Caronni
Guest Editor

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Keywords

  • Botulinum neurotoxins
  • Treatment outcome
  • Outcome measures
  • Spasticity
  • Movement disorders
  • Pain
  • Disability evaluation

Published Papers (1 paper)

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Research

10 pages, 746 KiB  
Article
An Observational Cross-Sectional Study of Gender and Disability as Determinants of Person-Centered Medicine in Botulinum Neurotoxin Treatment of Upper Motoneuron Syndrome
by Cristina Maria Del Prete, Mattia Giuseppe Viva, Stefania De Trane, Fabrizio Brindisino, Giovanni Barassi, Alessandro Specchia, Angelo Di Iorio and Raffaello Pellegrino
Toxins 2022, 14(4), 246; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins14040246 - 30 Mar 2022
Cited by 1 | Viewed by 1727
Abstract
The motor behaviour of patients with Upper Motor Neuron Syndrome (UMNS) is characterised by spasticity. The first-line treatment for this clinical condition is Botulinum neurotoxin A (BoNTA), but the number and key locations of muscles which need to be treated is not much [...] Read more.
The motor behaviour of patients with Upper Motor Neuron Syndrome (UMNS) is characterised by spasticity. The first-line treatment for this clinical condition is Botulinum neurotoxin A (BoNTA), but the number and key locations of muscles which need to be treated is not much discussed in the literature. Cross-sectional analysis of outpatient cohort with UMNS spasticity, who were potential candidates for BoNTA treatment, was performed. Between November 2020 and November 2021, all consecutive adult patients eligible for BoNTA treatment were enrolled. The inclusion criteria encompass UMNS spasticity (onset being ≥6 months), with disabling muscles hypertonia. Patients underwent a clinical evaluation, a comprehensive assessment with the Modified Ashworth Scale, with the Modified Rankin Scale, and a patients’ perception-centred questionnaire. In total, 68 participants were enrolled in the study, among them 40 (58.8%) were male; mean age 57.9 ± 15.1. In women, BoNTA was more frequently required for adductor group muscles, independently from potential confounders (OR = 7.03, 95%CI: 1.90–25.97). According to the pattern of disability, patients with hemiparesis more frequently need to be treated in the upper limb, whereas the diplegia/double-hemiparesis group needed to be treated more frequently at the adductor and crux muscles compared to their counterparts. UMNS spasticity in women could require more attention to be paid to the treatment of adductor muscle spasticity, potentially because the dysfunction of those muscles could influence sphincteric management, required for perineal hygiene and/or sexual life. Full article
(This article belongs to the Special Issue Evaluation of the Efficacy of Botulinum Neurotoxins)
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