Short- and Long-term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia

O'Flynn, Lena C.; Simonyan, Kristina

doi:10.1212/wnl.0000000000200850

Cited by 10 publications

(15 citation statements)

References 53 publications

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“…The first, by Hok et al [ 94 ], focuses on cervical dystonia, which has been linked both to disrupted cerebellar function and acquired etiologies. The second, by O’Flynn et al [ 115 ], focuses on a task specific focal dystonia, whose underpinning etiology and associated networks have remained more enigmatic.…”

Section: Clues To Dystonia Pathophysiology Derived From Therapeutic I...mentioning

confidence: 99%

“…Another recent study, performed by O’Flynn et al, furthers this conceptual framework by tackling a similar question in laryngeal dystonia [ 115 ]. In this study, the functional connectivity of 161 patients with laryngeal dystonia who had received short, intermediate, or long-term treatment with BoNT were examined using fcMRI.…”

Section: Clues To Dystonia Pathophysiology Derived From Therapeutic I...mentioning

confidence: 99%

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Function and dysfunction of the dystonia network: an exploration of neural circuits that underlie the acquired and isolated dystonias

Gill,

Nguyen,

Hull

et al. 2023

Dystonia

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Dystonia is a highly prevalent movement disorder that can manifest at any time across the lifespan. An increasing number of investigations have tied this disorder to dysfunction of a broad “dystonia network” encompassing the cerebellum, thalamus, basal ganglia, and cortex. However, pinpointing how dysfunction of the various anatomic components of the network produces the wide variety of dystonia presentations across etiologies remains a difficult problem. In this review, a discussion of functional network findings in non-mendelian etiologies of dystonia is undertaken. Initially acquired etiologies of dystonia and how lesion location leads to alterations in network function are explored, first through an examination of cerebral palsy, in which early brain injury may lead to dystonic/dyskinetic forms of the movement disorder. The discussion of acquired etiologies then continues with an evaluation of the literature covering dystonia resulting from focal lesions followed by the isolated focal dystonias, both idiopathic and task dependent. Next, how the dystonia network responds to therapeutic interventions, from the “geste antagoniste” or “sensory trick” to botulinum toxin and deep brain stimulation, is covered with an eye towards finding similarities in network responses with effective treatment. Finally, an examination of how focal network disruptions in mouse models has informed our understanding of the circuits involved in dystonia is provided. Together, this article aims to offer a synthesis of the literature examining dystonia from the perspective of brain networks and it provides grounding for the perspective of dystonia as disorder of network function.

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Section: Clues To Dystonia Pathophysiology Derived From Therapeutic I...mentioning

confidence: 99%

Section: Clues To Dystonia Pathophysiology Derived From Therapeutic I...mentioning

confidence: 99%

Function and dysfunction of the dystonia network: an exploration of neural circuits that underlie the acquired and isolated dystonias

Gill,

Nguyen,

Hull

et al. 2023

Dystonia

View full text Add to dashboard Cite

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“…What is more, BoNT can also be used for the treatment of some occupational dystonias, such as writer’s and musician’s cramps and stroke-related hemiplegia [ 186 ]. For laryngeal dystonia, characterized by spasmodic dysphonia, which manifests as either a laborious and tense sound that is interrupted by frequent articulatory interruptions and silent pauses, or a respiratory murmur, BoNT is also considered the treatment choice [ 187 ]. As for gastrointestinal, genitourinary, and sphincter disorders (such as achalasia, spasm of the sphincter of Oddi, and anal fissure [ 186 ]), the therapeutic efficacy of BoNT also acts on the spasm muscles in these organs [ 162 , 188 , 189 , 190 , 191 ].…”

Section: Clinical Applications Of Neurotoxinsmentioning

confidence: 99%

Neurotoxins Acting at Synaptic Sites: A Brief Review on Mechanisms and Clinical Applications

Zhou

Luo

Liu

et al. 2022

Toxins

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Neurotoxins generally inhibit or promote the release of neurotransmitters or bind to receptors that are located in the pre- or post-synaptic membranes, thereby affecting physiological functions of synapses and affecting biological processes. With more and more research on the toxins of various origins, many neurotoxins are now widely used in clinical treatment and have demonstrated good therapeutic outcomes. This review summarizes the structural properties and potential pharmacological effects of neurotoxins acting on different components of the synapse, as well as their important clinical applications, thus could be a useful reference for researchers and clinicians in the study of neurotoxins.

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“…More recently, functional MRI studies have shown reduced activity in specific brain regions (left precuneus region) in LD patients successfully treated with BoNT compared with unsuccessfully treated and untreated patients. Moreover, subtype-specific regions of decreased activity were noted for the adductor (ADLD) (right thalamus) and abductor (ABLD) (left inferior frontal cortex) variants respectively [54]. Studies evaluating symptomatic improvement with BoNT treatment or peripheral stimulation show direct effects on muscle spindle as well as normalisation of cortical sensory organisation and function [43,47,55], implying correction of proprioceptive dysfunction as a mechanism for therapeutic response.…”

Section: Mechanism Of Action Of Botulinum Toxin In Ldmentioning

confidence: 99%

Botulinum Neurotoxin Therapy in the Clinical Management of Laryngeal Dystonia

Yeung

Richards

Novakovic

2022

Toxins

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Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a chronic, task-specific, focal movement disorder affecting the larynx. It interferes primarily with the essential functions of phonation and speech. LD affects patients’ ability to communicate effectively and significantly diminishes their quality of life. Botulinum neurotoxin was first used as a therapeutic agent in the treatment of LD four decades ago and remains the standard of care for the treatment of LD. This article provides an overview of the clinical application of botulinum neurotoxin in the management of LD, focusing on the classification for this disorder, its pathophysiology, clinical assessment and diagnosis, the role of laryngeal electromyography and a summary of therapeutic injection techniques, including a comprehensive description of various procedural approaches, recommendations for injection sites and dosage considerations.

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Short- and Long-term Central Action of Botulinum Neurotoxin Treatment in Laryngeal Dystonia

Cited by 10 publications

References 53 publications

Function and dysfunction of the dystonia network: an exploration of neural circuits that underlie the acquired and isolated dystonias

Function and dysfunction of the dystonia network: an exploration of neural circuits that underlie the acquired and isolated dystonias

Neurotoxins Acting at Synaptic Sites: A Brief Review on Mechanisms and Clinical Applications

Botulinum Neurotoxin Therapy in the Clinical Management of Laryngeal Dystonia

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