Autonomic cardiovascular function and baroreflex sensitivity in patients with cervical dystonia receiving treatment with botulinum toxin type A

Tiple, Dorina; Strano, Stefano; Colosimo, Carlo; Fabbrini, Giovanni; Prencipe, Massimiliano; Berardelli, Alfredo

doi:10.1007/s00415-008-0753-6

Cited by 20 publications

(15 citation statements)

References 26 publications

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“…15,35 Chronic therapy with BoNTA induces subclinical changes in autonomic cardiovascular regulation and cardiopulmonary baroreflex sensitivity. 36 One case of complete atrioventricular block 3 weeks after BoNTA injection has been described, also suggesting an effect on the ANS. 37 A similar effect on the ANS has been described in foodborne botulism.…”

Section: Discussionmentioning

confidence: 98%

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Ruet

Durand

Denys

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Section: Discussionmentioning

confidence: 98%

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Ruet

Durand

Denys

et al. 2015

Archives of Physical Medicine and Rehabilitation

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“…Another measure of distal effect is evidence of autonomic change after BoNT injection. A short‐term power spectral analysis of heart rate and systolic blood pressure variability, high‐frequency and low‐frequency oscillations of heart rate variability, low frequency/high frequency ratio, and baroreflex sensitivity were measured in 12 patients with cervical dystonia before and 2 to 4 weeks after BoNT‐A injection and were compared with normative data . Their data demonstrated a dose‐dependent effect on neuromuscular transmission in distal muscles, possibly owing to hematogenous spread of the toxin through the bloodstream.…”

Section: Introduction Definitions and Biologic Propertiesmentioning

confidence: 91%

“…Overall, these results suggest that the effect of locally injected, intramuscular BoNT‐A on autonomic cardiovascular innervation cumulates over time. Furthermore, examination of residual urine volumes and of heart rate variability in patients injected with therapeutic doses of BoNT support systemic autonomic dysfunction . None of these findings, however, were noticed by the patient, nor were they clinically relevant.…”

Section: Introduction Definitions and Biologic Propertiesmentioning

confidence: 99%

Diffusion, spread, and migration of botulinum toxin

et al. 2013

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Botulinum toxin (BoNT) is an acetylcholine release inhibitor and a neuromuscular blocking agent used for the treatment of a variety of neurologic and medical conditions. The efficacy and safety of BoNT depends on accurate selection and identification of intended targets but also may be determined by other factors, including physical spread of the molecule from the injection site, passive diffusion, and migration to distal sites via axonal or hematogenous transport. The passive kinetic dispersion of the toxin away from the injection site in a gradient-dependent manner may also play a role in toxin spread. In addition to unique properties of the various BoNT products, volume and dilution may also influence local and systemic distribution of BoNT. Most of the local and remote complications of BoNT injections are thought to be due to unwanted spread or diffusion of the toxin's biologic activity into adjacent and distal muscles. Despite widespread therapeutic and cosmetic use of BoNT over more than three decades, there is a remarkable paucity of published data on the mechanisms of distribution and its effects on clinical outcomes. The primary aim of this article is to critically review the available experimental and clinical literature and place it in the practical context.

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“…In dystonia patients, most of the autonomic dysfunction is related mainly to treatment with anticholinergic medications or BoNT, and especially with BoNT B, although Tiple et al found that CD patients have mild, subclinical abnormalities in autonomic cardiovascular regulation, heart rate and systolic blood pressure variability, and cardiopulmonary baroreflex sensitivity prior to therapy, which do not worsen after BoNT-A injection [105]. Tinter et al reported patients treated with BoNT-B to have less saliva production and greater severity of constipation, than those treated with BoNT-A [106].…”

Section: Autonomic Dysfunctionmentioning

confidence: 99%

Non-Motor Symptoms in Patients with Primary Dystonia

Semerdjieva¹,

Milanov²

2018

Dystonia - Different Prospects

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Isolated dystonia, previously referred to as primary, is the third most common movement disorder, characterized by involuntary muscle contractions causing abnormal movements and postures with or without the presence of tremor. No matter monogenic or sporadic, the form of dystonia is a growing evidence, suggesting the presence of non-motor components to the disorder. Dystonia patients suffer from reduced quality of life, which might be related not only to the dystonic movements itself but to different non-motor symptoms and signs, as well. Based on literature review, this chapter aims to focus on the association of different types of isolated/primary dystonia (forms of focal, segmental, and generalized dystonia) with some non-motor disorders, including sleep and psychiatric disorders, cognition, as though as pain and sensory symptoms, their pathophysiological and biochemical mechanisms, relations with the symptomatic treating strategies for the abnormal movements, and specific treatment for the non-motor signs.

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Autonomic cardiovascular function and baroreflex sensitivity in patients with cervical dystonia receiving treatment with botulinum toxin type A

Abstract: Patients with cervical dystonia receiving treatment with botulinum toxin type A have mild, subclinical abnormalities in autonomic cardiovascular regulation and cardiopulmonary baroreflex sensitivity. These changes do not worsen after acute botulinum toxin type A injection.

Cited by 20 publications

References 26 publications

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Diffusion, spread, and migration of botulinum toxin

Non-Motor Symptoms in Patients with Primary Dystonia

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