Botulinum toxin treatment in parkinsonism

Anandan, Charenya; Jankovic, Joseph

doi:10.1016/j.jns.2023.122810

Cited by 6 publications

(5 citation statements)

References 81 publications

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“…Foot dystonia, produced by involuntary, repetitive, twisting contractions of muscles in the foot, occurs most often when carbidopa-levodopa wears off ( Jost, 2021 ; Anandan and Jankovic, 2023 ). This “wearing off” foot dystonia is usually characterized by ankle plantarflexion/inversion, with toes curling usually downward, but sometimes the toes (particularly the big toe) extend.…”

Section: Discussionmentioning

confidence: 99%

“…Oromandibular dystonia is relatively uncommon in PD, but it is a relatively common complication of levodopa therapy in MSA ( Anandan and Jankovic, 2023 ). Wearing off jaw dystonia has been reported to improve after BoNT injections ( Agarwal, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Dystonia is present in up to 30% of patients with Parkinson’s disease (PD) ( Anandan and Jankovic, 2023 ; Matar and Bhatia, 2023 ). In some cases of PD or other parkinsonian disorders, dystonia may be one of the motor features, and in other cases, dystonia may be the dominant movement disorder with parkinsonism as the secondary phenomenon, classified as “‘combined’ dystonias” ( Albanese et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

“…The non-aerobic bacteria Clostridium botulinum produces botulinum toxin (BoNT), the most potent biologic toxin ( Anandan and Jankovic, 2023 ). BoNT acts by blocking the release of acetylcholine at the neuromuscular junction, thus causing muscle weakness.…”

Section: Introductionmentioning

confidence: 99%

“…This property has been used for therapeutic purposes, including in the treatment of dystonia. There are many indications for BoNT in patients with PD and other parkinsonian disorders ( Jankovic, 2009 ; Cardoso, 2018 ; Jost, 2021 ; Lapostolle et al, 2022 ; Anandan and Jankovic, 2023 ; Jabbari and Comtesse, 2023 ). This article will focus on the use of BoNT in PD-associated dystonia.…”

Section: Introductionmentioning

confidence: 99%

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Use of botulinum toxin in the management of dystonia in Parkinson’s disease

Anandan,

Jankovic

2024

Front. Neurosci.

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Botulinum toxin is one of the most potent neurotoxins, but when injected into an overactive muscle, it can transiently alleviate an involuntary movement, such as dystonia. The primary aim of this article is to provide a comprehensive review of the various forms of dystonia observed in patients with Parkinson’s disease who can benefit from a therapeutic trial of botulinum toxin. Although most of these indications are not supported by randomized controlled clinical trials and, therefore, not approved by the Food and Drug Administration, there are many open-label trials supporting a large body of empirical experience testifying to the benefits of botulinum toxin treatment in these conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of botulinum toxin in the management of dystonia in Parkinson’s disease

Anandan,

Jankovic

2024

Front. Neurosci.

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Tips and tricks in tremor treatment

Hopfner,

Buhmann,

Classen

et al. 2024

J Neural Transm

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Tremor, whether arising from neurological diseases, other conditions, or medication side effects, significantly impacts patients' lives. Treatment complexities necessitate clear algorithms and strategies. Levodopa remains pivotal for Parkinson's tremor, though response variability exists. Some dopamine agonists offer notable tremor reduction targeting D2 receptors. Propranolol effectively manages essential tremor and essential tremor plus (ET/ET +), sometimes with primidone for added benefits, albeit dose-dependent side effects. As reserve medications anticholinergics and clozapine are used for treatment of parkinsonian tremor, 1-Octanol and certain anticonvulsant drugs for tremor of other orign, especially ET. Therapies such as invasive deep brain stimulation and lesional focused ultrasound serve for resistant cases. A medication review is crucial for all forms of tremor, but it is particularly important if medication may have triggered the tremor. Sensor-based detection and non-drug interventions like wristbands and physical therapy broaden diagnostic and therapeutic horizons, promising future tremor care enhancements. Understanding treatment nuances is a key for tailored tremor management respecting patient needs and tolerability. Successful strategies integrate pharmacological, non-invasive, and technological modalities, aiming for optimal symptom control and improved quality of life.

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