Botulinum Toxin and Deep Brain Stimulation in Dystonia.
Julia Carvalhinho Carlos de SouzaAnanda Carolina Moraes FalconeRenata Montes Garcia BarbosaMíriam Carvalho SoaresRenato MunhozMarina FarahTamine T C CapatoSara Carvalho Barbosa CasagrandeMarcela Ferreira CordelliniGabriel de Castro MicheliJoão Carlos Papaterra LimongiEgberto Reis BarbosaClarice ListikRubens Gisbert CuryPublished in: Toxins (2024)
Deep Brain Stimulation (DBS) is a recognized treatment for different dystonia subtypes and has been approved by the Food and Drug Administration (FDA) since 2003. The European Federation of Neurological Societies (EFNS) and the International Parkinson and Movement Disorders Society (MDS) recommend DBS for dystonia after failure of botulinum toxin (BoNT) and other oral medications for dystonia treatment. In addition, several long-term studies have demonstrated the continuous efficacy of DBS on motor and quality of life (QoL) scores. However, there are only a few reports comparing the overall impact of surgical treatment in BoNT protocols (e.g., dosage and number of selected muscles before and after surgery). This retrospective multicenter chart-review study analyzed botulinum toxin total dosage and dosage per muscle in 23 dystonic patients before and after DBS surgery. The study's primary outcome was to analyze whether there was a reduction in BoNT dosage after DBS surgery. The mean BoNT dosages difference between baseline and post-surgery was 293.4 units for 6 months, 292.6 units for 12 months, and 295.2 units at the last visit. The median total dose of BoNT in the preoperative period was 800 units (N = 23). At the last visit, the median was 700 units ( p = 0.05). This represents a 12.5% reduction in BoNT median dosage. In conclusion, despite the limitations of this retrospective study, there was a significant reduction in BoNT doses after DBS surgery in patients with generalized dystonia.
Keyphrases
- deep brain stimulation
- botulinum toxin
- parkinson disease
- minimally invasive
- obsessive compulsive disorder
- coronary artery bypass
- drug administration
- surgical site infection
- newly diagnosed
- ejection fraction
- cross sectional
- end stage renal disease
- skeletal muscle
- prognostic factors
- clinical trial
- percutaneous coronary intervention
- patients undergoing
- combination therapy
- coronary artery disease
- replacement therapy
- risk assessment
- climate change
- smoking cessation