Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections
Current pharmacological agents used to treat Parkinson disease (PD) tremor and essential tremor (ET) provide suboptimal benefit and are commonly associated with significant adverse effects. Botulinum toxin type A (BoNT-A) has been shown to be effective for wrist tremor though functionally bothersome...
Gespeichert in:
| Veröffentlicht in: | PloS one 2017-06, Vol.12 (6), p.e0178670-e0178670 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0178670 |
|---|---|
| container_issue | 6 |
| container_start_page | e0178670 |
| container_title | PloS one |
| container_volume | 12 |
| creator | Samotus, Olivia Lee, Jack Jog, Mandar |
| description | Current pharmacological agents used to treat Parkinson disease (PD) tremor and essential tremor (ET) provide suboptimal benefit and are commonly associated with significant adverse effects. Botulinum toxin type A (BoNT-A) has been shown to be effective for wrist tremor though functionally bothersome muscle weakness frequently occurs. This is the longest study to date demonstrating that BoNT-A therapy coupled with kinematic guidance can provide efficacious outcomes for upper limb tremor with minimized unwanted weakness.
A total of 28 PD and 24 ET participants with bothersome, disabling tremor, received six serial BoNT-A treatments every 16 weeks starting at week 0 with a follow-up visit 6 weeks following a treatment, totaling 96 weeks. Clinical scales, including Fahn-Tolosa-Marin tremor rating scale (FTM), and sensor-based tremor assessments were conducted at each visit. Kinematics was utilized to identify which arm muscles contributed to the tremulous movements and the experienced injector used clinical expertise in determining BoNT-A dosages.
Following BoNT-A treatment, clinical ratings of tremor severity and functional ability (FTM) showed significant improvements following the first treatment which was maintained up to week 96 in PD and ET. Kinematics detected a significant reduction in PD and ET tremor amplitudes by 70% and 76% over the treatment course, respectively. By objectively distinguishing tremulous muscles and tremor severity, adverse effects were limited to mild perceived weakness by participants in injected muscles during follow-ups. Following the fourth treatment, BoNT-A dosages in flexor and extensor wrist muscles and biceps were reduced for those experiencing residual weakness which ultimately did not interfere with tremor relief or arm function.
Kinematics is an objective method that can aid clinicians in assessing and determining optimal BoNT-A parameters to alleviate both PD and ET tremor. BoNT-A injections are tolerable and effective when focal therapy regimens are determined and optimized kinematically over a long-term. |
| doi_str_mv | 10.1371/journal.pone.0178670 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1906414945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A494560598</galeid><doaj_id>oai_doaj_org_article_53a5705fffb7426a84ffb9c707d079ad</doaj_id><sourcerecordid>A494560598</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-fdbb4dbca00622aa46517072032dee8fbc0754a84e8a5c6e451416c87c01a03</originalsourceid><addsrcrecordid>eNqNk1uL1DAUx4so7rr6DUQLguhDx6TNpX0RhsXLwMCKK76GNE07GdOkm6S68-3NzHSWreyD5KGH09_5n0tykuQlBAtYUPhha0dnuF4M1sgFgLQkFDxKzmFV5BnJQfH4nn2WPPN-CwAuSkKeJmd5iUtSUHCeDGtruixI16fByd66NGyk48MubaP9jbtfynhrUm6aVHovTVBcn9A_KmzS6PPWZd2oGtmktQ2jVmaMcvZWmTTsBpkuU2W2UgRljX-ePGm59vLF9L1Irj9_-nH5NVtffVldLteZIFUesrapa9TUggNA8pxzRDCkgMZe8kbKsq0FoBjxEsmSY0EkwhBBIkoqAOSguEheH1UHbT2bRuUZrABBEFUIR2J1JBrLt2xwquduxyxX7OCwrmPcBSW0ZLjgmALctm1NUU5i0mhVIpbTAFrxJmp9nLKNdS8bEafkuJ6Jzv8YtWGd_c0wIqBEKAq8mwScvRmlD6xXXkituZF2PNRNAShKsK_7zT_ow91NVMdjA8q0NuYVe1G23AME4KqM1OIBKp5G9krEd9Wq6J8FvJ8FRCbI29Dx0Xu2uv7-_-zVzzn79h67kVyHjbd6PLyYOYiOoHDWeyfbuyFDwPZrcZoG268Fm9Yihr26f0F3Qac9KP4CBakJqg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1906414945</pqid></control><display><type>article</type><title>Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Samotus, Olivia ; Lee, Jack ; Jog, Mandar</creator><contributor>Fasano, Alfonso</contributor><creatorcontrib>Samotus, Olivia ; Lee, Jack ; Jog, Mandar ; Fasano, Alfonso</creatorcontrib><description>Current pharmacological agents used to treat Parkinson disease (PD) tremor and essential tremor (ET) provide suboptimal benefit and are commonly associated with significant adverse effects. Botulinum toxin type A (BoNT-A) has been shown to be effective for wrist tremor though functionally bothersome muscle weakness frequently occurs. This is the longest study to date demonstrating that BoNT-A therapy coupled with kinematic guidance can provide efficacious outcomes for upper limb tremor with minimized unwanted weakness.
A total of 28 PD and 24 ET participants with bothersome, disabling tremor, received six serial BoNT-A treatments every 16 weeks starting at week 0 with a follow-up visit 6 weeks following a treatment, totaling 96 weeks. Clinical scales, including Fahn-Tolosa-Marin tremor rating scale (FTM), and sensor-based tremor assessments were conducted at each visit. Kinematics was utilized to identify which arm muscles contributed to the tremulous movements and the experienced injector used clinical expertise in determining BoNT-A dosages.
Following BoNT-A treatment, clinical ratings of tremor severity and functional ability (FTM) showed significant improvements following the first treatment which was maintained up to week 96 in PD and ET. Kinematics detected a significant reduction in PD and ET tremor amplitudes by 70% and 76% over the treatment course, respectively. By objectively distinguishing tremulous muscles and tremor severity, adverse effects were limited to mild perceived weakness by participants in injected muscles during follow-ups. Following the fourth treatment, BoNT-A dosages in flexor and extensor wrist muscles and biceps were reduced for those experiencing residual weakness which ultimately did not interfere with tremor relief or arm function.
Kinematics is an objective method that can aid clinicians in assessing and determining optimal BoNT-A parameters to alleviate both PD and ET tremor. BoNT-A injections are tolerable and effective when focal therapy regimens are determined and optimized kinematically over a long-term.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0178670</identifier><identifier>PMID: 28586370</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adrenergic beta-antagonists ; Adult ; Aged ; Aged, 80 and over ; Amplitudes ; Arm ; Assessments ; Biology and Life Sciences ; Biomechanics ; Botulinum toxin ; Botulinum toxin type A ; Botulinum Toxins, Type A - administration & dosage ; Botulinum Toxins, Type A - adverse effects ; Care and treatment ; Dentistry ; Dosage and administration ; Dose-Response Relationship, Drug ; Drug therapy ; Effectiveness ; Electromyography ; Essential Tremor - drug therapy ; Essential Tremor - physiopathology ; Ethics ; Female ; Functional anatomy ; Health sciences ; Humans ; Kinematics ; L-dopa ; Male ; Medical research ; Medicine and Health Sciences ; Middle Aged ; Movement disorders ; Muscle, Skeletal - drug effects ; Muscle, Skeletal - physiopathology ; Muscles ; Neurodegenerative diseases ; Neuromuscular Agents - administration & dosage ; Neuromuscular Agents - adverse effects ; Optimization ; Parkinson disease ; Parkinson Disease - drug therapy ; Parkinson Disease - physiopathology ; Parkinson's disease ; Parkinsons disease ; Pharmacology ; Physical Sciences ; Quality of life ; Ratings ; Research and Analysis Methods ; Sensors ; Side effects ; Studies ; Therapy ; Treatment Outcome ; Tremor ; Upper Extremity - physiopathology ; Wrist</subject><ispartof>PloS one, 2017-06, Vol.12 (6), p.e0178670-e0178670</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Samotus et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Samotus et al 2017 Samotus et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-fdbb4dbca00622aa46517072032dee8fbc0754a84e8a5c6e451416c87c01a03</citedby><cites>FETCH-LOGICAL-c692t-fdbb4dbca00622aa46517072032dee8fbc0754a84e8a5c6e451416c87c01a03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460844/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460844/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28586370$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Fasano, Alfonso</contributor><creatorcontrib>Samotus, Olivia</creatorcontrib><creatorcontrib>Lee, Jack</creatorcontrib><creatorcontrib>Jog, Mandar</creatorcontrib><title>Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Current pharmacological agents used to treat Parkinson disease (PD) tremor and essential tremor (ET) provide suboptimal benefit and are commonly associated with significant adverse effects. Botulinum toxin type A (BoNT-A) has been shown to be effective for wrist tremor though functionally bothersome muscle weakness frequently occurs. This is the longest study to date demonstrating that BoNT-A therapy coupled with kinematic guidance can provide efficacious outcomes for upper limb tremor with minimized unwanted weakness.
A total of 28 PD and 24 ET participants with bothersome, disabling tremor, received six serial BoNT-A treatments every 16 weeks starting at week 0 with a follow-up visit 6 weeks following a treatment, totaling 96 weeks. Clinical scales, including Fahn-Tolosa-Marin tremor rating scale (FTM), and sensor-based tremor assessments were conducted at each visit. Kinematics was utilized to identify which arm muscles contributed to the tremulous movements and the experienced injector used clinical expertise in determining BoNT-A dosages.
Following BoNT-A treatment, clinical ratings of tremor severity and functional ability (FTM) showed significant improvements following the first treatment which was maintained up to week 96 in PD and ET. Kinematics detected a significant reduction in PD and ET tremor amplitudes by 70% and 76% over the treatment course, respectively. By objectively distinguishing tremulous muscles and tremor severity, adverse effects were limited to mild perceived weakness by participants in injected muscles during follow-ups. Following the fourth treatment, BoNT-A dosages in flexor and extensor wrist muscles and biceps were reduced for those experiencing residual weakness which ultimately did not interfere with tremor relief or arm function.
Kinematics is an objective method that can aid clinicians in assessing and determining optimal BoNT-A parameters to alleviate both PD and ET tremor. BoNT-A injections are tolerable and effective when focal therapy regimens are determined and optimized kinematically over a long-term.</description><subject>Adrenergic beta-antagonists</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amplitudes</subject><subject>Arm</subject><subject>Assessments</subject><subject>Biology and Life Sciences</subject><subject>Biomechanics</subject><subject>Botulinum toxin</subject><subject>Botulinum toxin type A</subject><subject>Botulinum Toxins, Type A - administration & dosage</subject><subject>Botulinum Toxins, Type A - adverse effects</subject><subject>Care and treatment</subject><subject>Dentistry</subject><subject>Dosage and administration</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug therapy</subject><subject>Effectiveness</subject><subject>Electromyography</subject><subject>Essential Tremor - drug therapy</subject><subject>Essential Tremor - physiopathology</subject><subject>Ethics</subject><subject>Female</subject><subject>Functional anatomy</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Kinematics</subject><subject>L-dopa</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Muscle, Skeletal - drug effects</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Muscles</subject><subject>Neurodegenerative diseases</subject><subject>Neuromuscular Agents - administration & dosage</subject><subject>Neuromuscular Agents - adverse effects</subject><subject>Optimization</subject><subject>Parkinson disease</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson's disease</subject><subject>Parkinsons disease</subject><subject>Pharmacology</subject><subject>Physical Sciences</subject><subject>Quality of life</subject><subject>Ratings</subject><subject>Research and Analysis Methods</subject><subject>Sensors</subject><subject>Side effects</subject><subject>Studies</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Tremor</subject><subject>Upper Extremity - physiopathology</subject><subject>Wrist</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAUx4so7rr6DUQLguhDx6TNpX0RhsXLwMCKK76GNE07GdOkm6S68-3NzHSWreyD5KGH09_5n0tykuQlBAtYUPhha0dnuF4M1sgFgLQkFDxKzmFV5BnJQfH4nn2WPPN-CwAuSkKeJmd5iUtSUHCeDGtruixI16fByd66NGyk48MubaP9jbtfynhrUm6aVHovTVBcn9A_KmzS6PPWZd2oGtmktQ2jVmaMcvZWmTTsBpkuU2W2UgRljX-ePGm59vLF9L1Irj9_-nH5NVtffVldLteZIFUesrapa9TUggNA8pxzRDCkgMZe8kbKsq0FoBjxEsmSY0EkwhBBIkoqAOSguEheH1UHbT2bRuUZrABBEFUIR2J1JBrLt2xwquduxyxX7OCwrmPcBSW0ZLjgmALctm1NUU5i0mhVIpbTAFrxJmp9nLKNdS8bEafkuJ6Jzv8YtWGd_c0wIqBEKAq8mwScvRmlD6xXXkituZF2PNRNAShKsK_7zT_ow91NVMdjA8q0NuYVe1G23AME4KqM1OIBKp5G9krEd9Wq6J8FvJ8FRCbI29Dx0Xu2uv7-_-zVzzn79h67kVyHjbd6PLyYOYiOoHDWeyfbuyFDwPZrcZoG268Fm9Yihr26f0F3Qac9KP4CBakJqg</recordid><startdate>20170606</startdate><enddate>20170606</enddate><creator>Samotus, Olivia</creator><creator>Lee, Jack</creator><creator>Jog, Mandar</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170606</creationdate><title>Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections</title><author>Samotus, Olivia ; Lee, Jack ; Jog, Mandar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fdbb4dbca00622aa46517072032dee8fbc0754a84e8a5c6e451416c87c01a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adrenergic beta-antagonists</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amplitudes</topic><topic>Arm</topic><topic>Assessments</topic><topic>Biology and Life Sciences</topic><topic>Biomechanics</topic><topic>Botulinum toxin</topic><topic>Botulinum toxin type A</topic><topic>Botulinum Toxins, Type A - administration & dosage</topic><topic>Botulinum Toxins, Type A - adverse effects</topic><topic>Care and treatment</topic><topic>Dentistry</topic><topic>Dosage and administration</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug therapy</topic><topic>Effectiveness</topic><topic>Electromyography</topic><topic>Essential Tremor - drug therapy</topic><topic>Essential Tremor - physiopathology</topic><topic>Ethics</topic><topic>Female</topic><topic>Functional anatomy</topic><topic>Health sciences</topic><topic>Humans</topic><topic>Kinematics</topic><topic>L-dopa</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Movement disorders</topic><topic>Muscle, Skeletal - drug effects</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Muscles</topic><topic>Neurodegenerative diseases</topic><topic>Neuromuscular Agents - administration & dosage</topic><topic>Neuromuscular Agents - adverse effects</topic><topic>Optimization</topic><topic>Parkinson disease</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson's disease</topic><topic>Parkinsons disease</topic><topic>Pharmacology</topic><topic>Physical Sciences</topic><topic>Quality of life</topic><topic>Ratings</topic><topic>Research and Analysis Methods</topic><topic>Sensors</topic><topic>Side effects</topic><topic>Studies</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><topic>Tremor</topic><topic>Upper Extremity - physiopathology</topic><topic>Wrist</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samotus, Olivia</creatorcontrib><creatorcontrib>Lee, Jack</creatorcontrib><creatorcontrib>Jog, Mandar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samotus, Olivia</au><au>Lee, Jack</au><au>Jog, Mandar</au><au>Fasano, Alfonso</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-06-06</date><risdate>2017</risdate><volume>12</volume><issue>6</issue><spage>e0178670</spage><epage>e0178670</epage><pages>e0178670-e0178670</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Current pharmacological agents used to treat Parkinson disease (PD) tremor and essential tremor (ET) provide suboptimal benefit and are commonly associated with significant adverse effects. Botulinum toxin type A (BoNT-A) has been shown to be effective for wrist tremor though functionally bothersome muscle weakness frequently occurs. This is the longest study to date demonstrating that BoNT-A therapy coupled with kinematic guidance can provide efficacious outcomes for upper limb tremor with minimized unwanted weakness.
A total of 28 PD and 24 ET participants with bothersome, disabling tremor, received six serial BoNT-A treatments every 16 weeks starting at week 0 with a follow-up visit 6 weeks following a treatment, totaling 96 weeks. Clinical scales, including Fahn-Tolosa-Marin tremor rating scale (FTM), and sensor-based tremor assessments were conducted at each visit. Kinematics was utilized to identify which arm muscles contributed to the tremulous movements and the experienced injector used clinical expertise in determining BoNT-A dosages.
Following BoNT-A treatment, clinical ratings of tremor severity and functional ability (FTM) showed significant improvements following the first treatment which was maintained up to week 96 in PD and ET. Kinematics detected a significant reduction in PD and ET tremor amplitudes by 70% and 76% over the treatment course, respectively. By objectively distinguishing tremulous muscles and tremor severity, adverse effects were limited to mild perceived weakness by participants in injected muscles during follow-ups. Following the fourth treatment, BoNT-A dosages in flexor and extensor wrist muscles and biceps were reduced for those experiencing residual weakness which ultimately did not interfere with tremor relief or arm function.
Kinematics is an objective method that can aid clinicians in assessing and determining optimal BoNT-A parameters to alleviate both PD and ET tremor. BoNT-A injections are tolerable and effective when focal therapy regimens are determined and optimized kinematically over a long-term.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28586370</pmid><doi>10.1371/journal.pone.0178670</doi><tpages>e0178670</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-06, Vol.12 (6), p.e0178670-e0178670 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1906414945 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adrenergic beta-antagonists Adult Aged Aged, 80 and over Amplitudes Arm Assessments Biology and Life Sciences Biomechanics Botulinum toxin Botulinum toxin type A Botulinum Toxins, Type A - administration & dosage Botulinum Toxins, Type A - adverse effects Care and treatment Dentistry Dosage and administration Dose-Response Relationship, Drug Drug therapy Effectiveness Electromyography Essential Tremor - drug therapy Essential Tremor - physiopathology Ethics Female Functional anatomy Health sciences Humans Kinematics L-dopa Male Medical research Medicine and Health Sciences Middle Aged Movement disorders Muscle, Skeletal - drug effects Muscle, Skeletal - physiopathology Muscles Neurodegenerative diseases Neuromuscular Agents - administration & dosage Neuromuscular Agents - adverse effects Optimization Parkinson disease Parkinson Disease - drug therapy Parkinson Disease - physiopathology Parkinson's disease Parkinsons disease Pharmacology Physical Sciences Quality of life Ratings Research and Analysis Methods Sensors Side effects Studies Therapy Treatment Outcome Tremor Upper Extremity - physiopathology Wrist |
| title | Long-term tremor therapy for Parkinson and essential tremor with sensor-guided botulinum toxin type A injections |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T22%3A48%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-term%20tremor%20therapy%20for%20Parkinson%20and%20essential%20tremor%20with%20sensor-guided%20botulinum%20toxin%20type%20A%20injections&rft.jtitle=PloS%20one&rft.au=Samotus,%20Olivia&rft.date=2017-06-06&rft.volume=12&rft.issue=6&rft.spage=e0178670&rft.epage=e0178670&rft.pages=e0178670-e0178670&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0178670&rft_dat=%3Cgale_plos_%3EA494560598%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1906414945&rft_id=info:pmid/28586370&rft_galeid=A494560598&rft_doaj_id=oai_doaj_org_article_53a5705fffb7426a84ffb9c707d079ad&rfr_iscdi=true |