The clinical utility of botulinum toxin injections targeted at the motor endplate zone in cervical dystonia

C.C.S. Delnooz, L.C. Veugen, J.W. Pasman, B.G. Lapatki, J.P. van Dijk, B.P.C. van de Warrenburg

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

10 Citaten (Scopus)

Samenvatting

BACKGROUND AND PURPOSE: Cervical dystonia (CD) patients usually receive repeated botulinum neurotoxin (BoNT) injections. The aims of this study were to evaluate the feasibility of motor endplate zone (MEZ) detection of relevant cervical muscles in CD patients receiving chronic BoNT treatment and to compare the treatment effect of half-dosed, endplate-targeted injections to standard BoNT injections.

METHODS: In study 1, high-density surface electromyography (HD-sEMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SC) muscles in 18 CD patients with ongoing BoNT treatment, by which the location of the MEZ was determined. In study 2, nine additional patients with rotational-type CD participated in a treatment effect study where they received either half of their regular BoNT dose through endplate-targeted injections or their normal BoNT dose through standard injections (crossover design). Dystonia severity was recorded before and 4 weeks after each treatment session (Toronto Western Spasmodic Torticollis Rating Scale severity subscore).

RESULTS: In the SCM muscle the MEZ was located at the lower border of the superior third part of the muscle, and in the SC muscle at half muscle length. Endplate-targeted, half-dosed BoNT injection resulted in a similar treatment effect to injecting the full dose in the standard technique.

CONCLUSIONS: Half-dosed, endplate-targeted BoNT injections lead to a similar treatment effect to the standard BoNT injection protocol. MEZ detection confronts the clinician with some technical challenges, such as the ability of accurate and technically optimal placement of the electrode grid and correct interpretation of the HD-sEMG signal.

Originele taal-2Engels
Pagina's (van-tot)1486-1492
TijdschriftEuropean Journal of Neurobiology
Volume21
Nummer van het tijdschrift12
DOI's
StatusGepubliceerd - dec 2014
Extern gepubliceerdJa

Bibliografische nota

© 2014 EAN.

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  • Citeer dit

    Delnooz, C. C. S., Veugen, L. C., Pasman, J. W., Lapatki, B. G., van Dijk, J. P., & van de Warrenburg, B. P. C. (2014). The clinical utility of botulinum toxin injections targeted at the motor endplate zone in cervical dystonia. European Journal of Neurobiology, 21(12), 1486-1492. https://doi.org/10.1111/ene.12517