Cargando…
Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
Lateral trunk flexion (LTF) and its severe form, called Pisa syndrome (PS), are highly invalidating axial postural abnormalities associated with Parkinson’s disease (PD). Management strategies for LTF lack strong scientific evidence. We present a real-life, longitudinal study evaluating long-term ef...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536312/ https://www.ncbi.nlm.nih.gov/pubmed/37755992 http://dx.doi.org/10.3390/toxins15090566 |
_version_ | 1785112836004904960 |
---|---|
author | Ledda, Claudia Panero, Elisa Dimanico, Ugo Parisi, Mattia Gandolfi, Marialuisa Tinazzi, Michele Geroin, Christian Marchet, Francesco Massazza, Giuseppe Lopiano, Leonardo Artusi, Carlo Alberto |
author_facet | Ledda, Claudia Panero, Elisa Dimanico, Ugo Parisi, Mattia Gandolfi, Marialuisa Tinazzi, Michele Geroin, Christian Marchet, Francesco Massazza, Giuseppe Lopiano, Leonardo Artusi, Carlo Alberto |
author_sort | Ledda, Claudia |
collection | PubMed |
description | Lateral trunk flexion (LTF) and its severe form, called Pisa syndrome (PS), are highly invalidating axial postural abnormalities associated with Parkinson’s disease (PD). Management strategies for LTF lack strong scientific evidence. We present a real-life, longitudinal study evaluating long-term efficacy of botulinum toxin (BoNT) injections in axial muscles to reduce LTF and PS in PD. A total of 13 PD patients with LTF > 5° received ultrasound- and electromyography-guided BoNT injections every 4 months. Seven untreated matched PD patients with LTF served as controls and their changes in posture after 18 months were compared with those of seven patients continuing BoNT over 12 months. 53.8% of patients continued the BoNT injections for at least 12 months. Various individual LTF responses were observed. Overall, BoNT-treated patients obtained a not statistically significant improvement of LTF of 17 ± 41% (p = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (p = 0.116), showing a significantly different trajectory of posture change (p = 0.026). In conclusion, repeated BoNT injections in axial muscles showed varying effects in managing PD-associated LTF, suggesting that: (a) a relevant number of patients with LTF can benefit from BoNT; (b) long-term treatment could prevent LTF worsening; (c) an instrumented, personalized approach is important; and (d) there is a need for prospective, long-term studies. |
format | Online Article Text |
id | pubmed-10536312 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-105363122023-09-29 Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study Ledda, Claudia Panero, Elisa Dimanico, Ugo Parisi, Mattia Gandolfi, Marialuisa Tinazzi, Michele Geroin, Christian Marchet, Francesco Massazza, Giuseppe Lopiano, Leonardo Artusi, Carlo Alberto Toxins (Basel) Article Lateral trunk flexion (LTF) and its severe form, called Pisa syndrome (PS), are highly invalidating axial postural abnormalities associated with Parkinson’s disease (PD). Management strategies for LTF lack strong scientific evidence. We present a real-life, longitudinal study evaluating long-term efficacy of botulinum toxin (BoNT) injections in axial muscles to reduce LTF and PS in PD. A total of 13 PD patients with LTF > 5° received ultrasound- and electromyography-guided BoNT injections every 4 months. Seven untreated matched PD patients with LTF served as controls and their changes in posture after 18 months were compared with those of seven patients continuing BoNT over 12 months. 53.8% of patients continued the BoNT injections for at least 12 months. Various individual LTF responses were observed. Overall, BoNT-treated patients obtained a not statistically significant improvement of LTF of 17 ± 41% (p = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (p = 0.116), showing a significantly different trajectory of posture change (p = 0.026). In conclusion, repeated BoNT injections in axial muscles showed varying effects in managing PD-associated LTF, suggesting that: (a) a relevant number of patients with LTF can benefit from BoNT; (b) long-term treatment could prevent LTF worsening; (c) an instrumented, personalized approach is important; and (d) there is a need for prospective, long-term studies. MDPI 2023-09-11 /pmc/articles/PMC10536312/ /pubmed/37755992 http://dx.doi.org/10.3390/toxins15090566 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ledda, Claudia Panero, Elisa Dimanico, Ugo Parisi, Mattia Gandolfi, Marialuisa Tinazzi, Michele Geroin, Christian Marchet, Francesco Massazza, Giuseppe Lopiano, Leonardo Artusi, Carlo Alberto Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title | Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title_full | Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title_fullStr | Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title_full_unstemmed | Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title_short | Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study |
title_sort | longitudinal assessment of botulinum toxin treatment for lateral trunk flexion and pisa syndrome in parkinson’s disease: real-life, long-term study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536312/ https://www.ncbi.nlm.nih.gov/pubmed/37755992 http://dx.doi.org/10.3390/toxins15090566 |
work_keys_str_mv | AT leddaclaudia longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT paneroelisa longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT dimanicougo longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT parisimattia longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT gandolfimarialuisa longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT tinazzimichele longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT geroinchristian longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT marchetfrancesco longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT massazzagiuseppe longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT lopianoleonardo longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy AT artusicarloalberto longitudinalassessmentofbotulinumtoxintreatmentforlateraltrunkflexionandpisasyndromeinparkinsonsdiseasereallifelongtermstudy |