Personalized botulinum toxin type A therapy for cervical dystonia based on kinematic guidance

Personalized botulinum toxin type A therapy for cervical dystonia based on kinematic guidance Background Botulinum toxin type A (BoNT-A) injections is the accepted first-line therapy for cervical dystonia (CD), however, numerous patients discontinue treatment early due to perceived sub-optimal relief. To improve BoNT-A therapy for CD, proper assessment of neck motion and selection of relevant muscles and dosing must be met. Kinematic technology may improve treatment outcomes by guiding physicians to better tailor muscle selection and BoNT-A dosing for CD therapy. Methods 28 CD participants were placed into either group: expert injector determined injection patterns by visual assessment (“vb”) versus injection patterns based on kinematics interpreted by an expert injector (“kb”). Injections occurred at weeks 0, 16 and 32 with follow-ups at weeks 6, 22 and 38. Kinematics utilized four sensors to capture the severity of multiaxial, static neck posturing (e.g., torticollis) and dynamic, spasmodic/tremor movements while participants were seated. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score changes were evaluated over 38 weeks. Results For the “kb” participants, there was a significant 28.8% (− 11.25 points) reduction in TWSTRS total score at week 6, as well as significant reduction in severity and disability TWSTRS sub-scores (parts I and II) with maintained improve - ment at subsequent visits. As for the “vb” participants had http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Neurology Springer Journals

Personalized botulinum toxin type A therapy for cervical dystonia based on kinematic guidance

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Neurology; Neurosciences; Neuroradiology
ISSN
0340-5354
eISSN
1432-1459
D.O.I.
10.1007/s00415-018-8819-6
Publisher site
See Article on Publisher Site

Abstract

Background Botulinum toxin type A (BoNT-A) injections is the accepted first-line therapy for cervical dystonia (CD), however, numerous patients discontinue treatment early due to perceived sub-optimal relief. To improve BoNT-A therapy for CD, proper assessment of neck motion and selection of relevant muscles and dosing must be met. Kinematic technology may improve treatment outcomes by guiding physicians to better tailor muscle selection and BoNT-A dosing for CD therapy. Methods 28 CD participants were placed into either group: expert injector determined injection patterns by visual assessment (“vb”) versus injection patterns based on kinematics interpreted by an expert injector (“kb”). Injections occurred at weeks 0, 16 and 32 with follow-ups at weeks 6, 22 and 38. Kinematics utilized four sensors to capture the severity of multiaxial, static neck posturing (e.g., torticollis) and dynamic, spasmodic/tremor movements while participants were seated. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score changes were evaluated over 38 weeks. Results For the “kb” participants, there was a significant 28.8% (− 11.25 points) reduction in TWSTRS total score at week 6, as well as significant reduction in severity and disability TWSTRS sub-scores (parts I and II) with maintained improve - ment at subsequent visits. As for the “vb” participants had

Journal

Journal of NeurologySpringer Journals

Published: Mar 20, 2018

References

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