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Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or CervicalDystonia: A Review of Clinical Effectiveness Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or CervicalDystonia: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or CervicalDystonia: A Review of Clinical Effectiveness Switching Botulinum Toxin A Products for Patients (...) with Upper Limb Spasticity or CervicalDystonia: A Review of Clinical Effectiveness Last updated: February 9, 2018 Project Number: RC0960-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of switching botulinum toxin A products for patients with upper limb spasticity? What is the clinical effectiveness of switching botulinum toxin A products for patients with cervicaldystonia? Key Message No literature
Botulinum toxin type A therapy for cervicaldystonia. This is an update of a Cochrane Review first published in 2005. Cervicaldystonia is the most common form of focal dystonia and is a highly disabling movement disorder characterised by involuntary, usually painful, head posturing. Currently, botulinum toxin type A (BtA) is considered the first line therapy for this condition.To compare the efficacy, safety, and tolerability of botulinum toxin type A (BtA) versus placebo in people (...) was improvement in cervicaldystonia-specific impairment. The primary safety outcome was the proportion of participants with any adverse event.We included eight RCTs of moderate overall risk of bias, including 1010 participants with cervicaldystonia. Six studies excluded participants with poorer responses to BtA treatment, therefore including an enriched population with a higher probability of benefiting from this therapy. Only one trial was independently funded. All RCTs evaluated the effect of a single BtA
Botulinum toxin type A versus botulinum toxin type B for cervicaldystonia. This is an update of a Cochrane review first published in 2003. Cervicaldystonia is the most common form of focal dystonia and is a disabling disorder characterised by painful involuntary head posturing. There are two available formulations of botulinum toxin, with botulinum toxin type A (BtA) usually considered the first line therapy for this condition. Botulinum toxin type B (BtB) is an alternative option (...) at the time. Therefore, with this update we are able to change the conclusions of this review. There is low quality evidence that a single treatment session of BtA (specifically onabotulinumtoxinA) and a single treatment session of BtB (rimabotulinumtoxinB) are equally effective and safe in the treatment of adults with certain types of cervicaldystonia. Treatment with BtB appears to present an increased risk of sore throat/dry mouth, compared to BtA. Overall, there is no clinical evidence from
Botulinum toxin type B for cervicaldystonia. This is an update of a Cochrane review first published in 2004, and previously updated in 2009 (no change in conclusions). Cervicaldystonia is a frequent and disabling disorder characterised by painful involuntary head posturing. Botulinum toxin type A (BtA) is usually considered the first line therapy for this condition, although botulinum toxin type B (BtB) is an alternative option.To compare the efficacy, safety and tolerability of botulinum (...) . The primary efficacy outcome was overall improvement on any validated symptomatic rating scale. The primary safety outcome was the number of participants with any adverse event.We included four RCTs of moderate overall methodological quality, including 441 participants with cervicaldystonia. Three studies excluded participants known to have poorer response to Bt treatment, therefore including an enriched population with a higher probability of benefiting from Bt treatment. None of the trials were
Botulinum neurotoxin for the treatment of blepharospasm, cervicaldystonia, adult spasticity, and headache Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervicaldystonia, adult spasticity, and headache | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share May 10, 2016 ; 86 (19) Special Article Practice guideline update summary (...) : Botulinum neurotoxin for the treatment of blepharospasm, cervicaldystonia, adult spasticity, and headache Report of the Guideline Development Subcommittee of the American Academy of Neurology David M. Simpson , Mark Hallett , Eric J. Ashman , Cynthia L. Comella , Mark W. Green , Gary S. Gronseth , Melissa J. Armstrong , David Gloss , Sonja Potrebic , Joseph Jankovic , Barbara P. Karp , Markus Naumann , Yuen T. So , Stuart A. Yablon First published April 18, 2016, DOI: https://doi.org/10.1212/WNL
Abnormal cerebellar connectivity and plasticity in isolated cervicaldystonia. There is increasing evidence that supports the role of the cerebellum in the pathophysiology of dystonia. We used transcranial magnetic stimulation to test the hypothesis that patients with cervicaldystonia may have a disrupted cerebellar cortical connectivity at rest, and that cerebellar plasticity is altered too. We enrolled 12 patients with isolated cervicaldystonia and 13 controls. A paired-pulse transcranial (...) was able to inhibit the amplitude of the motor evoked potentials from primary motor cortex. In healthy subjects continuous and intermittent cerebellar Theta Burst Stimulation were able to decrease and increase respectively motor cortex excitability. Continuous Theta Burst Stimulation was able to abolish the cerebellar cortical inhibition observed in basal condition. These effects were not observed in patients with cervicaldystonia. Cerebellar cortical connectivity and cerebellar plasticity is altered
Injectable DaxibotulinumtoxinA in CervicalDystonia: A Phase 2 Doseâ€Escalation Multicenter Study Injectable daxibotulinumtoxinA (an investigational botulinum toxin, RT002) may offer a more prolonged duration of response-and therefore less frequent dosing-than onabotulinumtoxinA.To perform a phase 2, open-label, dose-escalation study to assess the efficacy and safety of daxibotulinumtoxinA in cervical dystonia.Subjects with moderate-to-severe isolated cervicaldystonia were enrolled (...) site erythema (8%).Preliminary assessments suggest that injectable daxibotulinumtoxinA at doses up to 450 U is well tolerated and may offer prolonged efficacy in the treatment of cervicaldystonia. Further studies involving larger numbers of patients are now warranted.
Randomised controlled trial of escitalopram for cervicaldystonia with dystonic jerks/tremor Trials for additional or alternative treatments for cervicaldystonia (CD) are scarce since the introduction of botulinum neurotoxin (BoNT). We performed the first trial to investigate whether dystonic jerks/tremor in patients with CD respond to the selective serotonin reuptake inhibitor (SSRI) escitalopram.In a randomised, double-blind, crossover trial, patients with CD received escitalopram (...) and placebo for 6 weeks. Treatment with BoNT was continued, and scores on rating scales regarding dystonia, psychiatric symptoms and quality of life (QoL) were compared. Primary endpoint was the proportion of patients that improved at least one point on the Clinical Global Impression Scale for jerks/tremor scored by independent physicians with experience in movement disorders.Fifty-threepatients were included. In the escitalopram period, 14/49 patients (29%) improved on severity of jerks/tremor versus 11
The Frequency and Selfâ€perceived Impact on Daily Life of Motor and Nonâ€motor Symptoms in CervicalDystonia Evidence suggests that non-motor symptoms (NMS) are the most important predictors of decreased health-related quality of life (HR-QoL) in patients with cervicaldystonia (CD). In this study, we evaluate an NMS screening list and examine the influence of motor symptoms and NMS on HR-QoL.In 40 patients with CD, the frequency of NMS was evaluated using an extended NMS questionnaire (...) . Several domains of HR-QoL were significantly influenced by NMS, whereas motor symptoms had only a small influence on the physical functioning domain of HR-QoL.Our findings highlight the impact of NMS on HR-QoL and emphasize the importance of a standardized, validated NMS questionnaire for patients with dystonia. This would enable us to monitor the effect of treatment for motor symptoms and NMS on an individual basis and improve treatment options.
Providing an imputation algorithm for missing values of longitudinal data using Cuckoo search algorithm: A case study on cervicaldystonia Missing values in data are found in a large number of studies in the field of medical sciences, especially longitudinal ones, in which repeated measurements are taken from each person during the study. In this regard, several statistical endeavors have been performed on the concepts, issues, and theoretical methods during the past few decades.Herein, we (...) focused on the missing data related to patients excluded from longitudinal studies. To this end, two statistical parameters of similarity and correlation coefficient were employed. In addition, metaheuristic algorithms were applied to achieve an optimal solution. The selected metaheuristic algorithm, which has a great search functionality, was the Cuckoo search algorithm.Profiles of subjects with cervicaldystonia (CD) were used to evaluate the proposed model after applying missingness
A systematic review of the barriers and facilitators to the use of Botulinum toxin in cervicaldystonia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files
A systematic review of barriers and facilitators to participation in physical activity in people with cervicaldystonia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any
Network localization of cervicaldystonia based on causal brain lesions. Cervicaldystonia is a neurological disorder characterized by sustained, involuntary movements of the head and neck. Most cases of cervicaldystonia are idiopathic, with no obvious cause, yet some cases are acquired, secondary to focal brain lesions. These latter cases are valuable as they establish a causal link between neuroanatomy and resultant symptoms, lending insight into the brain regions causing cervicaldystonia (...) and possible treatment targets. However, lesions causing cervicaldystonia can occur in multiple different brain locations, leaving localization unclear. Here, we use a technique termed 'lesion network mapping', which uses connectome data from a large cohort of healthy subjects (resting state functional MRI, n = 1000) to test whether lesion locations causing cervicaldystonia map to a common brain network. We then test whether this network, derived from brain lesions, is abnormal in patients
Cervical sensorimotor control in idiopathic cervicaldystonia: AÂ crossâ€sectional study Patients with idiopathic adult-onset cervicaldystonia (CD) experience an abnormal head posture and involuntary muscle contractions. Although the exact areas affected in the central nervous system remain uncertain, impaired functions in systems stabilizing the head and neck are apparent such as the somatosensory and sensorimotor integration systems. The aim of the study is to investigate cervical (...) ). Disease-specific characteristics of all patients were obtained via the Tsui scale, CervicalDystonia Impact Profile (CDIP-58), and Toronto Western Spasmodic Rating Scale.Patients with CD showed larger JPE than controls (mean difference of 1.5°, p < .006), and systematically 'overshoot', i.e. surpassed the NHP, whereas control subjects 'undershoot', i.e. fall behind the NHP. The JPE did not correlate with disease-specific characteristics.Cervical sensorimotor control is impaired in patients with CD
IncobotulinumtoxinA (XEOMIN), injection of, for blepharospasm, cervicaldystonia (spasmodic torticollis) and post-stroke spasticity of the upper limb IncobotulinumtoxinA (XEOMIN), injection of, for blepharospasm, cervicaldystonia (spasmodic torticollis) and post-stroke spasticity of the upper limb IncobotulinumtoxinA (XEOMIN), injection of, for blepharospasm, cervicaldystonia (spasmodic torticollis) and post-stroke spasticity of the upper limb Medical Services Advisory Committee Record Status (...) This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Medical Services Advisory Committee. IncobotulinumtoxinA (XEOMIN), injection of, for blepharospasm, cervicaldystonia (spasmodic torticollis) and post-stroke spasticity of the upper limb. Canberra: Medical Services Advisory Committee (MSAC). MSAC application 1379. 2014 Authors' objectives Blepharospasm is a chronic progressive disorder, defined
Does dystonic muscle activity affect sense of effort in cervicaldystonia? Focal dystonia has been associated with deficient processing of sense of effort cues. However, corresponding studies are lacking in cervicaldystonia (CD). We hypothesized that dystonic muscle activity would perturb neck force control based on sense of effort cues.Neck extension force control was investigated in 18 CD patients with different clinical features (7 with and 11 without retrocollis) and in 19 control subjects
Fatigue, Sleep Disturbances, and Their Influence on Quality of Life in CervicalDystonia Patients Nonmotor symptoms (NMS) are highly prevalent in cervicaldystonia (CD). In general, fatigue and sleep are important NMS that determine a decreased health-related quality of life (HR-QoL), but their influence in CD is unknown. The authors systematically investigated fatigue, excessive daytime sleepiness (EDS), and sleep quality in patients with CD and controls and assessed the influence (...) of psychiatric comorbidity, pain, and dystonia motor severity. They also examined the predictors of HR-QoL.The study included 44 patients with CD and 43 matched controls. Fatigue, EDS, and sleep quality were assessed with quantitative questionnaires and corrected for depression and anxiety using analysis of covariance. The Toronto Western Spasmodic Torticollis Rating Scale and the Clinical Global Impression Scale-jerks/tremor subscale were used to score motor severity and to assess whether motor
High Botulinum Toxinâ€Neutralizing Antibody Prevalence Under Longâ€Term CervicalDystonia Treatment The aim of this study was to determine the prevalence of neutralizing antibodies in a large cohort of long-term treated patients with cervicaldystonia (CD) still responding to repetitive injections with botulinum toxin (BoNT).Consecutively recruited CD patients (n = 221) under long-term BoNT treatment (≥2-21 years) underwent a clinical examination at the same time blood samples were taken
and exam presence of risk factors simultaneous contraction of agonist and antagonist muscles muscle pain appearance or worsening of dystonia with action blepharospasm cervical torticollis hand spasms foot spasms acute presentation (within 5 days of exposure to antidopaminergic agent) acute worsening of pre-existing generalised dystonia twisting of the affected body part geste antagoniste (sensory trick) spread to another body part parkinsonism myoclonus tremor, weakness, or spasticity reflex (...) DystoniasDystonias - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Dystonias Last reviewed: February 2019 Last updated: January 2019 Summary Movement disorder characterised by sustained involuntary muscle contractions and abnormal postures of the trunk, neck, face, or extremities. The involuntary movements are associated with simultaneous contraction of agonist and antagonist muscles, with unwanted 'overflow