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Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions
, 2
Affiliations- Medical University of Gdansk, Poland, Gdansk, Poland
- Parkinson-Klinik Ortenau, Wolfach, Germany, Germany
open access
Abstract
Cervical dystonia (CD) usually presents a complex pattern of head/neck movements accompanied by tremor, myoclonic jerks and a wide spectrum of non-motor disturbances such as pain, depression, anxiety, and sleep problems. This is the most challenging indication for botulinum neurotoxin (BoNT) treatment. It can offer significant improvement, but it can be difficult after the first injection. Thorough examination and identification of the proper CD pattern, the identification of the muscles responsible, and adjusting doses given precisely under ultrasound and/or electromyographic guidance seem to be the key success modifiers. Nevertheless, this is a lifelong treatment and should be planned and conducted carefully to avoid failures and drop outs. The aim of this paper was to examine the current concepts in terms of anatomy, physiology and CD patterns (Col-Cap concept) as well as the proper dosages and any possible obstacles impeding successful treatment.
Abstract
Cervical dystonia (CD) usually presents a complex pattern of head/neck movements accompanied by tremor, myoclonic jerks and a wide spectrum of non-motor disturbances such as pain, depression, anxiety, and sleep problems. This is the most challenging indication for botulinum neurotoxin (BoNT) treatment. It can offer significant improvement, but it can be difficult after the first injection. Thorough examination and identification of the proper CD pattern, the identification of the muscles responsible, and adjusting doses given precisely under ultrasound and/or electromyographic guidance seem to be the key success modifiers. Nevertheless, this is a lifelong treatment and should be planned and conducted carefully to avoid failures and drop outs. The aim of this paper was to examine the current concepts in terms of anatomy, physiology and CD patterns (Col-Cap concept) as well as the proper dosages and any possible obstacles impeding successful treatment.
Keywords
botulinum neurotoxin, cervical dystonia, electromyography, ultrasonography, deep brain stimulation
About this articleTitle
Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Invited Review Article
Pages
125-132
Published online
2021-04-06
Page views
1542
Article views/downloads
1423
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2021;55(2):125-132.
Keywords
botulinum neurotoxin
cervical dystonia
electromyography
ultrasonography
deep brain stimulation
Authors
Jarosław Sławek
Wolfgang H. Jost
References (50)- Reichel G. Cervical dystonia: A new phenomenological classification for botulinum toxin therapy. Basal Ganglia. 2011; 1(1): 5–12.
- Rodrigues FB, Duarte GS, Prescott D, et al. Deep brain stimulation for dystonia. Cochrane Database Syst Rev. 2019; 1: CD012405.
- Simpson DM, Hallett M, Ashman EJ, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016; 86(19): 1818–1826.
- Rodrigues FB, Duarte GS, Marques RE, et al. Botulinum toxin type A therapy for cervical dystonia. Cochrane Database Syst Rev. 2020; 11: CD003633.
- Tyślerowicz M, Kiedrzyńska W, Adamkiewicz B, et al. Cervical dystonia - improving the effectiveness of botulinum toxin therapy. Neurol Neurochir Pol. 2020; 54(3): 232–242.
- Jost WH, Tatu L. Selection of Muscles for Botulinum Toxin Injections in Cervical Dystonia. Mov Disord Clin Pract. 2015; 2(3): 224–226.
- Tatu L, Jost WH. Anatomy and cervical dystonia : "Dysfunction follows form". J Neural Transm (Vienna). 2017; 124(2): 237–243.
- Jost W. Botulinumtoxintherapie der zervikalen Dystonie – Schritt für Schritt. Neurologie up2date. 2019; 2(02): 125–130.
- Jost WH, Biering-Sørensen Bo, Drużdż A, et al. Preferred muscles in cervical dystonia. Neurol Neurochir Pol. 2020; 54(3): 277–279.
- Jost WH, Tatu L, Pandey S, et al. Frequency of different subtypes of cervical dystonia. J Neural Transm. 2020; 127: 45–50.
- Pandey S, Kreisler A, Drużdż A, et al. Tremor in Idiopathic Cervical Dystonia - Possible Implications for Botulinum Toxin Treatment Considering the Col-Cap Classification. Tremor Other Hyperkinet Mov (N Y). 2020; 10: 13.
- Allergan, Ltd. BOTOX® 100 U. Summary of product characteristics [webpage on the Internet]. Surrey, UK: Datapharm Communications Ltd; 2013 [updated December 12, 2012]. Available from: http://www.medicines.org.uk/emc/medicine/112. Accessed October. ; 8: 2020.
- Dysport® (abobotulinumtoxinA) [prescribing information]. Boulogne-Billancourt: IpsenBiopharm Ltd; 2012. Accessed October 8. 2020.
- XEOMIN (50/100/200) units powder for solution for injection – summary of product characteristics. https://www medicines ie/medicines/xeomin-50-100-200-units-powder-for-solution-for-injection-34858/spc. ; November 2019.
- Spiegel LL, Ostrem JL, Bledsoe IO. FDA Approvals and Consensus Guidelines for Botulinum Toxins in the Treatment of Dystonia. Toxins (Basel). 2020; 12(5).
- Jost WH, Drużdż A, Pandey S, et al. Dose per muscle in cervical dystonia: pooled data from seven movement disorder centres. Neurol Neurochir Pol. 2021 [Epub ahead of print].
- Bentivoglio AR, Bagella CF, Albanese A. Botulinum toxin in movement disorders. In: Jankovic J, Tolosa E (eds) Parkinson’s disease & Movement Disorders 2015, 6th edn. Wolters Kluver, Philadelphia, pp. : 480–495.
- Albanese A, Abbruzzese G, Dressler D, et al. Practical guidance for CD management involving treatment of botulinum toxin: a consensus statement. J Neurol. 2015; 262(10): 2201–2213.
- Walter U, Mühlenhoff C, Benecke R, et al. Frequency and risk factors of antibody-induced secondary failure of botulinum neurotoxin therapy. Neurology. 2020; 94(20): e2109–e2120.
- Wu C, Xue F, Chang W, et al. Botulinum toxin type A with or without needle electromyographic guidance in patients with cervical dystonia. Springerplus. 2016; 5(1): 1292.
- Schramm A, Bäumer T, Fietzek U, et al. Relevance of sonography for botulinum toxin treatment of cervical dystonia: an expert statement. J Neural Transm (Vienna). 2015; 122(10): 1457–1463.
- Tyślerowicz M, Jost WH. Injection into the longus colli muscle via the thyroid gland. Tremor Other Hyperkinet Mov (N Y). 2019; 9. indexed in Pubmed: 31867133. .
- Kreisler A, Gerrebout C, Defebvre L, et al. Accuracy of non-guided versus ultrasound-guided injections in cervical muscles: a cadaver study. J Neurol. 2021 [Epub ahead of print].
- Brumpt E, Aubry S, Vuillier F, et al. Anatomo-sonographic identification of the longissimus capitis and splenius cervicis muscles: principles for possible application to ultrasound-guided botulinum toxin injections in cervical dystonia. Surg Radiol Anat. 2021 [Epub ahead of print].
- Ko YD, Yun SIn, Ryoo D, et al. Accuracy of Ultrasound-Guided and Non-guided Botulinum Toxin Injection Into Neck Muscles Involved in Cervical Dystonia: A Cadaveric Study. Ann Rehabil Med. 2020; 44(5): 370–377.
- Jost W. Torticaput versus Torticollis: Clinical Effects with Modified Classification and Muscle Selection. Tremor and Other Hyperkinetic Movements. 2019; 9(0).
- Hong JS, Sathe GG, Niyonkuru C, et al. Elimination of dysphagia using ultrasound guidance for botulinum toxin injections in cervical dystonia. Muscle Nerve. 2012; 46(4): 535–539.
- Klingelhoefer L, Martino D, Martinez-Martin P, et al. Nonmotor symptoms and focal cervical dystonia: Observations from 102 patients. Basal Ganglia. 2014; 4(3-4): 117–120.
- Klingelhoefer L, Kaiser M, Sauerbier A, et al. Emotional well-being and pain could be a greater determinant of quality of life compared to motor severity in cervical dystonia. J Neural Transm (Vienna). 2021; 128(3): 305–314.
- Kuyper DJ, Parra V, Aerts S, et al. Nonmotor manifestations of dystonia: a systematic review. Mov Disord. 2011; 26(7): 1206–1217.
- Slawek J, Friedman A, Potulska A, et al. Factors affecting the health-related quality of life of patients with cervical dystonia and the impact of botulinum toxin type A injections. Funct Neurol. 2007; 22(2): 95–100.
- Berardelli I, Ferrazzano G, Pasquini M, et al. Clinical course of psychiatric disorders in patients with cervical dystonia. Psychiatry Res. 2015; 229(1-2): 583–585.
- Sitek EJ, Sołtan W, Wieczorek D, et al. Self-awareness of motor dysfunction in patients with Huntington's disease in comparison to Parkinson's disease and cervical dystonia. J Int Neuropsychol Soc. 2011; 17(5): 788–795.
- Stamelou M, Edwards M, Hallett M, et al. Stamelou M, Edwards M, Hallett M, Bathia K, The non-motor syndrome of primary dystonia: clinical and pathophysiological implications. Brain. 2012; 135(6): 1668-81.
- Jost WH, Hefter H, Stenner A, et al. Rating scales for cervical dystonia: a critical evaluation of tools for outcome assessment of botulinum toxin therapy. J Neural Transm (Vienna). 2013; 120(3): 487–496.
- Supnet ML, Acuna P, Carr SJ, et al. Isolated Cervical Dystonia: Management and Barriers to Care. Front Neurol. 2020; 11: 591418.
- Berlot R, Bhatia KP, Kojović M. Pseudodystonia: A new perspective on an old phenomenon. Parkinsonism Relat Disord. 2019; 62: 44–50.
- Dulski J, Sławek J. Fibrodysplasia ossificans progressiva as a form of pseudodystonia. Parkinsonism Relat Disord. 2020; 77: 180–181.
- Hefter H, Schomaecker I, Schomaecker M, et al. Disease Progression of Idiopathic Cervical Dystonia in Spite of Improvement After Botulinum Toxin Therapy. Front Neurol. 2020; 11: 588395.
- Marciniec M, Szczepańska-Szerej A, Rejdak K. Cervical dystonia: factors deteriorating patient satisfaction of long-term treatment with botulinum toxin. Neurol Res. 2020; 42(11): 987–991.
- Marciniec M, Szczepańska-Szerej A, Popek-Marciniec S, et al. Pain incidence in cervical dystonia is determined by the disease phenotype. J Clin Neurosci. 2020; 79: 133–136.
- Comella C, Ferreira JJ, Pain E, et al. Patient perspectives on the therapeutic profile of botulinum neurotoxin type A in cervical dystonia. J Neurol. 2021; 268(3): 903–912.
- Dressler D. Five-year experience with incobotulinumtoxinA (Xeomin(®) ): the first botulinum toxin drug free of complexing proteins. Eur J Neurol. 2012; 19(3): 385–389.
- Esquenazi A, Delgado MR, Hauser RA, et al. Duration of Symptom Relief Between Injections for AbobotulinumtoxinA (Dysport®) in Spastic Paresis and Cervical Dystonia: Comparison of Evidence From Clinical Studies. Front Neurol. 2020; 11: 576117.
- Marion MH, Humberstone M, Grunewald R, et al. British Neurotoxin Network recommendations for managing cervical dystonia in patients with a poor response to botulinum toxin. Pract Neurol. 2016; 16(4): 288–295.
- Moro E, LeReun C, Krauss JK, et al. Efficacy of pallidal stimulation in isolated dystonia: a systematic review and meta-analysis. Eur J Neurol. 2017; 24(4): 552–560.
- Ravindran K, Ganesh Kumar N, Englot DJ, et al. Deep Brain Stimulation Versus Peripheral Denervation for Cervical Dystonia: A Systematic Review and Meta-Analysis. World Neurosurg. 2019; 122: e940–e946.
- Kaelin-Lang A, You H, Burgunder JM, et al. Bilateral pallidal stimulation improves cervical dystonia for more than a decade. Parkinsonism Relat Disord. 2020; 81: 78–81.
- Wang J, Li J, Han L, et al. Selective peripheral denervation for the treatment of spasmodic torticollis: long-term follow-up results from 648 patients. Acta Neurochir (Wien). 2015; 157(3): 427–33; discussion 433.
- Cohen-Gadol AA, Ahlskog JE, Matsumoto JY, et al. Selective peripheral denervation for the treatment of intractable spasmodic torticollis: experience with 168 patients at the Mayo Clinic. J Neurosurg. 2003; 98(6): 1247–1254.
