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Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series

Botulinum toxin type A (BoNT-A) injections guided by kinematic analysis for unilateral upper limb essential tremor (ET) and Parkinson’s disease (PD) tremor therapy has demonstrated efficacy, improvements in quality of life (QoL) and arm functionality. In this open-label pilot trial, 5 ET and 2 PD pa...

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Autores principales: Samotus, Olivia, Lee, Jack, Jog, Mandar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215170/
https://www.ncbi.nlm.nih.gov/pubmed/30262746
http://dx.doi.org/10.3390/toxins10100394
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author Samotus, Olivia
Lee, Jack
Jog, Mandar
author_facet Samotus, Olivia
Lee, Jack
Jog, Mandar
author_sort Samotus, Olivia
collection PubMed
description Botulinum toxin type A (BoNT-A) injections guided by kinematic analysis for unilateral upper limb essential tremor (ET) and Parkinson’s disease (PD) tremor therapy has demonstrated efficacy, improvements in quality of life (QoL) and arm functionality. In this open-label pilot trial, 5 ET and 2 PD participants decided to switch from receiving long-term unilateral arm treatment to now bilateral BoNT-A arm therapy in their other tremulous arm which worsened over time. Injection patterns were based on kinematic analysis. Efficacy endpoints including kinematic analysis, Fahn-Tolosa-Marin tremor rating scale, QoL questionnaire, and maximal grip strength were collected over 2 treatments and 2 follow-up visits totaling 18-weeks. BoNT-A decreased wrist tremor amplitude by 84.6% and 89.6% 6-weeks following the 1st injection in the newly-treated limb in ET and PD participants, respectively. PD participants started with worse QoL but demonstrated an additional improvement in QoL by 29.9% for switching to bilateral treatment, whereas ET participants did not. Left and right arm tremor also did not share commonalities in severity or dose. This preliminary finding suggests trends for transitioning to bilateral therapy and warrants further studies to evaluate efficacy of bilateral tremor BoNT-A therapy in a larger cohort of PD and ET patients.
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spelling pubmed-62151702018-11-13 Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series Samotus, Olivia Lee, Jack Jog, Mandar Toxins (Basel) Article Botulinum toxin type A (BoNT-A) injections guided by kinematic analysis for unilateral upper limb essential tremor (ET) and Parkinson’s disease (PD) tremor therapy has demonstrated efficacy, improvements in quality of life (QoL) and arm functionality. In this open-label pilot trial, 5 ET and 2 PD participants decided to switch from receiving long-term unilateral arm treatment to now bilateral BoNT-A arm therapy in their other tremulous arm which worsened over time. Injection patterns were based on kinematic analysis. Efficacy endpoints including kinematic analysis, Fahn-Tolosa-Marin tremor rating scale, QoL questionnaire, and maximal grip strength were collected over 2 treatments and 2 follow-up visits totaling 18-weeks. BoNT-A decreased wrist tremor amplitude by 84.6% and 89.6% 6-weeks following the 1st injection in the newly-treated limb in ET and PD participants, respectively. PD participants started with worse QoL but demonstrated an additional improvement in QoL by 29.9% for switching to bilateral treatment, whereas ET participants did not. Left and right arm tremor also did not share commonalities in severity or dose. This preliminary finding suggests trends for transitioning to bilateral therapy and warrants further studies to evaluate efficacy of bilateral tremor BoNT-A therapy in a larger cohort of PD and ET patients. MDPI 2018-09-27 /pmc/articles/PMC6215170/ /pubmed/30262746 http://dx.doi.org/10.3390/toxins10100394 Text en © 2018 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Samotus, Olivia
Lee, Jack
Jog, Mandar
Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title_full Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title_fullStr Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title_full_unstemmed Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title_short Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series
title_sort transitioning from unilateral to bilateral upper limb tremor therapy for parkinson’s disease and essential tremor using botulinum toxin: case series
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215170/
https://www.ncbi.nlm.nih.gov/pubmed/30262746
http://dx.doi.org/10.3390/toxins10100394
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