Efficacy of single-photon emission computed tomography aided botulinum toxin injection in cervical dystonia: A double-blind, randomized study.
Adult
Botulinum Toxins, Type A
/ administration & dosage
Double-Blind Method
Female
Humans
Injections, Intramuscular
/ methods
Male
Middle Aged
Neuromuscular Agents
/ administration & dosage
Prospective Studies
Tomography, Emission-Computed, Single-Photon
Torticollis
/ drug therapy
Treatment Outcome
(99m)Technetium-sestamibi
Botulinum toxin
Cervical dystonia
Single-photon emission computed tomography
Journal
Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
31
05
2021
revised:
04
08
2021
accepted:
06
09
2021
pubmed:
20
9
2021
medline:
9
2
2022
entrez:
19
9
2021
Statut:
ppublish
Résumé
Although single-photon emission computed tomography (SPECT/CT) could help to predetermine dystonic muscles in patients with cervical dystonia (CD), its efficacy in aiding botulinum toxin injection is undetermined. This randomized, double-blinded study aimed to assess the efficacy of SPECT/CT aided botulinum toxin injection in CD. Patients were randomized into study group (candidate muscles selected by SPECT/CT and clinical evaluation) or control group (clinical evaluation). Follow-ups were done at two weeks (T1), one (T2), three (T3) and six months (T4). The primary outcomes included symptom improvement assessed using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tsui score at T2. A total of 122 patients were enrolled and 108 patients accomplished the study. For primary outcomes, the study group had significantly better symptom improvement at T2 (TWSTRS: β, -4.86 [95%CI -9.40 to -0.32; P = 0.036]; Tsui: β, -1.65 [95%CI -2.77 to -0.54; P = 0.004]). For secondary outcomes, the study group also showed better outcomes at T1 (TWSTRS: β, -6.33 [95%CI -10.17 to -2.49; P = 0.001]; Tsui: β, -1.42 [95%CI -2.48 to -0.37; P = 0.008]) and T3 (TWSTRS: β, -6.05 [95%CI -11.09 to -1.01; P = 0.019]; Tsui: β, -1.24 [95%CI -2.40 to -0.08; P = 0.037]). The interval of re-injection was significantly longer in the study group than the control group (159.1 ± 28.6 versus 141.8 ± 51.0 days, P = 0.032). SPECT/CT could improve the efficacy of botulinum toxin in CD. It could become a useful tool to aid botulinum toxin injection.
Sections du résumé
BACKGROUND
Although single-photon emission computed tomography (SPECT/CT) could help to predetermine dystonic muscles in patients with cervical dystonia (CD), its efficacy in aiding botulinum toxin injection is undetermined. This randomized, double-blinded study aimed to assess the efficacy of SPECT/CT aided botulinum toxin injection in CD.
METHODS
Patients were randomized into study group (candidate muscles selected by SPECT/CT and clinical evaluation) or control group (clinical evaluation). Follow-ups were done at two weeks (T1), one (T2), three (T3) and six months (T4). The primary outcomes included symptom improvement assessed using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tsui score at T2.
RESULTS
A total of 122 patients were enrolled and 108 patients accomplished the study. For primary outcomes, the study group had significantly better symptom improvement at T2 (TWSTRS: β, -4.86 [95%CI -9.40 to -0.32; P = 0.036]; Tsui: β, -1.65 [95%CI -2.77 to -0.54; P = 0.004]). For secondary outcomes, the study group also showed better outcomes at T1 (TWSTRS: β, -6.33 [95%CI -10.17 to -2.49; P = 0.001]; Tsui: β, -1.42 [95%CI -2.48 to -0.37; P = 0.008]) and T3 (TWSTRS: β, -6.05 [95%CI -11.09 to -1.01; P = 0.019]; Tsui: β, -1.24 [95%CI -2.40 to -0.08; P = 0.037]). The interval of re-injection was significantly longer in the study group than the control group (159.1 ± 28.6 versus 141.8 ± 51.0 days, P = 0.032).
CONCLUSIONS
SPECT/CT could improve the efficacy of botulinum toxin in CD. It could become a useful tool to aid botulinum toxin injection.
Identifiants
pubmed: 34537494
pii: S1353-8020(21)00331-X
doi: 10.1016/j.parkreldis.2021.09.002
pii:
doi:
Substances chimiques
Neuromuscular Agents
0
Botulinum Toxins, Type A
EC 3.4.24.69
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
77-82Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.