Botulinum toxin and neuromotor rehabilitation: An integrated approach to idiopathic cervical dystonia

  title={Botulinum toxin and neuromotor rehabilitation: An integrated approach to idiopathic cervical dystonia},
  author={Cristina Tassorelli and Francesca Mancini and Laura Balloni and Claudio Pacchetti and Giorgio Sandrini and Giuseppe Nappi and Emilia Martignoni},
  journal={Movement Disorders},
Currently, the best treatment option for idiopathic cervical dystonia (ICD) is injection of botulinum toxin (BTX) into the affected muscles, whereas rehabilitative approaches have given disappointing results. We evaluated whether the association of an ad hoc rehabilitative program may improve the clinical efficacy of BTX treatment in a single‐center, cross‐over, controlled study. Forty patients with ICD were randomly assigned to two different treatment groups: (1) BTX type A (BTX‐A) plus a… 
Effects of A 3-Month Physiotherapy Intervention in Stable Cervical Dystonia As Add-On to Botulinum Toxin Therapy
Multimodal physiotherapy is a feasible and save additional treatment option for patients with cervical dystonia, and patients benefited especially with improved range of motion, and reduced pain and severity of symptoms.
Cervical dystonia : Muscle selection for botulinum toxin treatment
Clinical evaluation combined with polymyographic EMG recordings (polymyography) is the best approach to identify dystonic muscles for BoNT treatment and autospectral changes might provide more insight in the pathophysiology of CD.
Study protocol: multimodal physiotherapy as an add-on treatment to botulinum neurotoxin type A therapy for patients with cervical dystonia: DysPT-multi—a prospective, multicentre, single-blind, randomized, controlled study
This largest randomized controlled trial in this field to date is intended to generate missing evidence for therapy guidelines and determine the effectiveness and therefore potential benefit of an additional multimodal physiotherapy for standardized treatment with BoNT-A in patients with CD.
Botulinum toxin assessment, intervention and aftercare for cervical dystonia and other causes of hypertonia of the neck: international consensus statement
More research is needed to answer questions about safety and efficacy in secondary spastic neck dystonia, effective adjunctive therapy, dosing and favourable injection techniques.
Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin
While the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds.
Patient perspectives on the therapeutic profile of botulinum neurotoxin type A in cervical dystonia
This survey highlights the burden of CD symptoms, even in patients undergoing regular treatment, and greater awareness of the therapeutic profile of BoNT-A treatment should lead to better informed therapeutic discussions and planning.
The effectiveness of physiotherapy for cervical dystonia: a systematic literature review
Investigation of the effectiveness of physiotherapy alone or as an adjuvant treatment to BoNT/A injections in cervical dystonia by means of a systematic literature review finds promising results.


The course of cervical dystonia and patient satisfaction with long‐term botulinum toxin A treatment
In 78 patients with idiopathic cervical dystonia (CD), the course of the disease and the patients’ satisfaction with long‐term botulinum toxin A (BTX) treatment was studied and 67% of the patients were characterized as having a good effect, and 33% an unsatisfactory effect.
The effect of two different rehabilitation treatments in cervical dystonia: preliminary results in four patients.
The physiotherapy program proposed in the present study showed therapeutic effects comparable to those of EMG biofeedback and may be a promising method for rehabilitation of cervical dystonia.
Efficacy and safety of botulinum type A toxin (Dysport) in cervical dystonia: Results of the first US randomized, double‐blind, placebo‐controlled study
  • D. TruongD. Duane G. Sheean
  • Medicine, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 2005
The results confirm previous reports that Dysport (500 units) is safe, effective, and well‐tolerated in patients with cervical dystonia.
Efficacy of pharmacological treatment of dystonia: evidence‐based review including meta‐analysis of the effect of botulinum toxin and other cure options
A literature review based on MEDLINE and the Cochrane Library and manual search of the most important journals was performed to identify the relevant publications issued between 1973 and 2003 concluded that botulinum toxin has obvious benefit and trihexyphenidyl in high dosages is effective for the treatment of segmental and generalized dystonia in young patients.
Therapeutic uses of botulinum toxin.
Botulinum toxin type A, one of the most lethal biologic toxins, has been found to be of therapeutic value in the treatment of a variety of neurologic and ophthalmologic disorders.
Tolcapone: COMT inhibition for the treatment of Parkinson's disease.
  • S. Fahn
  • Medicine, Biology
  • 1998
This supplement is a compilation of much of the pivotal clinical data on tolcapone, a new class of drugs, catechol O -methyltrasferase (COMT) inhibitors, has shown promise for treating PD in Phase III clinical studies.
Mutations in TITF-1 are associated with benign hereditary chorea.
Evidence is reported that mutations in TITF-1 are associated with BHC, a homeodomain-containing transcription factor essential for the organogenesis of the lung, thyroid and the basal ganglia.
Epidemiology of primary dystonia
Choreoathetosis, hypothyroidism, and pulmonary alterations due to human NKX2-1 haploinsufficiency.
The association of symptoms in the patients with NKX1-1 mutations points to an important role of human NKX2-1 in the development and function of thyroid, basal ganglia, and lung, as already described for rodents.