Do Diagnostic Nerve Blocks Affect the Starting Dose of Botulinum Neurotoxin Type A for Spasticity? A Case-Control Study-Reference-Cited by-同舟云学术

Do Diagnostic Nerve Blocks Affect the Starting Dose of Botulinum Neurotoxin Type A for Spasticity? A Case-Control Study

Published:2024-09-06 Issue:9 Volume:16 Page:388
ISSN:2072-6651
Container-title:Toxins
language:en
Short-container-title:Toxins

Author:

Filippetti Mirko¹²^ORCID,Tamburin Stefano¹^ORCID,Di Censo Rita¹³^ORCID,Aldegheri Roberto¹,Mantovani Elisa¹^ORCID,Spina Stefania⁴^ORCID,Battaglia Marco⁵^ORCID,Baricich Alessio⁶⁷,Santamato Andrea⁴^ORCID,Smania Nicola¹³^ORCID,Picelli Alessandro¹²³^ORCID

Affiliation:

1. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy

2. Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON K7K 1Z6, Canada

3. Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, 37100 Verona, Italy

4. Spasticity and Movement Disorders ‘ReSTaRt’ Unit, Physical Medicine and Rehabilitation Section, Policlinico Riuniti Hospital University of Foggia, 71122 Foggia, Italy

5. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy

6. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy

7. IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy

Abstract

One of the aims of diagnostic nerve blocks is to identify the overactive muscles that lead to a specific spasticity pattern. However, to date, there is no evidence on how nerve blocks may affect botulinum neurotoxin-A (BoNT-A) dose in patients with spasticity. This case-control study aims to assess the role of diagnostic nerve block in defining BoNT-A starting dose at first treatment. Patients with upper and lower limb spasticity treated for the first time with BoNT-A were retrospectively divided into two groups: Group 1 (n = 43) was evaluated with clinical assessment and diagnostic nerve block; Group 2 (n = 56) underwent clinical assessment only. Group 1 was injected with higher BoNT-A doses in some muscles (i.e., flexor digitorum profundus, soleus), and received a higher BoNT-A cumulative dose with a larger number of injected muscles for some spasticity patterns (i.e., “clenched fist”, “flexed fingers”, “adducted thigh”). Diagnostic nerve block may help the clinician to optimize and personalize the BoNT-A dose since the first BoNT-A treatment.

Publisher

MDPI AG

Link

https://www.mdpi.com/2072-6651/16/9/388/pdf

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