Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: An observational longitudinal study

Abstract

Botulinum toxin type A (BoNT-A) is the treatment of choice for focal spasticity, with a concomitant effect on pain reduction and improvement of quality of life (QoL). Current evidence of its efficacy is based mainly on post stroke spasticity. This study aims to clarify the role of BoNT-A in the context of non-stroke spasticity (NSS). We enrolled 86 patients affected by multiple sclerosis, spinal cord injury, and traumatic brain injury with clinical indication to perform BoNT-A treatment. Subjects were evaluated before injection and after 1, 3, and 6 months. At every visit, spasticity severity using the modified Ashworth scale, pain using the numeric rating scale, QoL using the Euro Qol Group EQ-5D-5L, and the perceived treatment effect using the Global Assessment of Efficacy scale were recorded. In our population BoNT-A demonstrated to have a significant effect in improving all the outcome variables, with different effect persistence over time in relation to the diagnosis and the number of treated sites. Our results support BoNT-A as a modifier of the disability condition and suggest its implementation in the treatment of NSS, delivering a possible starting point to generate diagnosis-specific follow-up programs.Clinical trial identifierNCT04673240.

The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis

“…In conclusion, the evidence from these studies suggests that BoNT-A is a viable and effective treatment option for non-stroke spasticity in conditions such as multiple sclerosis, SCI, and traumatic brain injury. Its ability to improve functional outcomes, pain management, and quality of life, coupled with a favorable safety profile, emphasizes its utility in clinical practice [ 105 ]. However, ongoing research, including randomized clinical trials, remains crucial to further establish the efficacy of, and optimize treatment protocols for, BoNT-A in managing non-stroke spasticity.…”

Virtual Reality for Decreasing Procedural Pain during Botulinum Toxin Injection Related to Spasticity Treatment in Adults: A Pilot Study

“…Pain intensity, considered as the primary endpoint, was determined using a numerical rating scale (NRS) ranging from 0 (no pain) to 10 (maximum imaginable pain) [32,33]. The patient reported the pain experienced during previous injections without VR before injection and the pain experienced in the current procedure with VR after the end of the procedure.…”

The Use of Botulinum Toxin for Spasticity in People Affected by Spinal Cord Injury: A Scoping Review Protocol

“…BoNT injections have been proven to be an effective intervention to treat focal spasticity in Stroke, Cerebral Palsy and Multiple Sclerosis. [12][13][14] In SCI, BoNT has found a consolidated indication in neurogenic detrusor overactivity treatment 15 , while its use for spasticity is currently an evolving field of research and clinical practice. To the best of our knowledge, the most recent systematic review 16 aimed to assess the efficacy of BoNT chemodenervation, phenol and alcohol neurolysis in people affected by spasticity following SCI dates back to 2015 and has shown the lack of high-quality evidence, advocating for further research in the field.…”