Cargando…

Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia

This observational study aimed at investigating pain in stroke patients with upper limb spastic dystonia. Forty-one consecutive patients were enrolled. A 0–10 numeric rating scale was used to evaluate pain at rest and during muscle tone assessment. Patients were asked to indicate the most painful jo...

Descripción completa

Detalles Bibliográficos
Autores principales: Trompetto, Carlo, Marinelli, Lucio, Mori, Laura, Puce, Luca, Avanti, Chiara, Saretti, Elena, Biasotti, Giulia, Amella, Roberta, Cotellessa, Filippo, Restivo, Domenico A., Currà, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780435/
https://www.ncbi.nlm.nih.gov/pubmed/35051017
http://dx.doi.org/10.3390/toxins14010039
_version_ 1784637837339000832
author Trompetto, Carlo
Marinelli, Lucio
Mori, Laura
Puce, Luca
Avanti, Chiara
Saretti, Elena
Biasotti, Giulia
Amella, Roberta
Cotellessa, Filippo
Restivo, Domenico A.
Currà, Antonio
author_facet Trompetto, Carlo
Marinelli, Lucio
Mori, Laura
Puce, Luca
Avanti, Chiara
Saretti, Elena
Biasotti, Giulia
Amella, Roberta
Cotellessa, Filippo
Restivo, Domenico A.
Currà, Antonio
author_sort Trompetto, Carlo
collection PubMed
description This observational study aimed at investigating pain in stroke patients with upper limb spastic dystonia. Forty-one consecutive patients were enrolled. A 0–10 numeric rating scale was used to evaluate pain at rest and during muscle tone assessment. Patients were asked to indicate the most painful joint at passive mobilization (shoulder, elbow, wrist-fingers). The DN4 questionnaire was administered to disclose neuropathic pain. All patients were assessed just before and 1 month after incobotulinumtoxin-A treatment. Pain was present in 22 patients, worsened or triggered by passive muscle stretching. DN4 scored < 4 in 20 patients. The most painful joints were wrist–fingers in 12 patients, elbow in 5 patients and shoulder in the remaining 5 patients. Both elbow and wrist–fingers pain correlated with muscle tone. BoNT-A treatment reduced pain in all the joints, including the shoulder. We discussed that nociceptive pain is present in a vast proportion of patients with upper limb spastic dystonia. BoNT-A treatment reduced both spastic dystonia and pain in all the joints but the shoulder, where the effect on pain could be mediated by the reduction of pathological postures involving the other joints.
format Online
Article
Text
id pubmed-8780435
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87804352022-01-22 Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia Trompetto, Carlo Marinelli, Lucio Mori, Laura Puce, Luca Avanti, Chiara Saretti, Elena Biasotti, Giulia Amella, Roberta Cotellessa, Filippo Restivo, Domenico A. Currà, Antonio Toxins (Basel) Article This observational study aimed at investigating pain in stroke patients with upper limb spastic dystonia. Forty-one consecutive patients were enrolled. A 0–10 numeric rating scale was used to evaluate pain at rest and during muscle tone assessment. Patients were asked to indicate the most painful joint at passive mobilization (shoulder, elbow, wrist-fingers). The DN4 questionnaire was administered to disclose neuropathic pain. All patients were assessed just before and 1 month after incobotulinumtoxin-A treatment. Pain was present in 22 patients, worsened or triggered by passive muscle stretching. DN4 scored < 4 in 20 patients. The most painful joints were wrist–fingers in 12 patients, elbow in 5 patients and shoulder in the remaining 5 patients. Both elbow and wrist–fingers pain correlated with muscle tone. BoNT-A treatment reduced pain in all the joints, including the shoulder. We discussed that nociceptive pain is present in a vast proportion of patients with upper limb spastic dystonia. BoNT-A treatment reduced both spastic dystonia and pain in all the joints but the shoulder, where the effect on pain could be mediated by the reduction of pathological postures involving the other joints. MDPI 2022-01-05 /pmc/articles/PMC8780435/ /pubmed/35051017 http://dx.doi.org/10.3390/toxins14010039 Text en © 2022 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
Trompetto, Carlo
Marinelli, Lucio
Mori, Laura
Puce, Luca
Avanti, Chiara
Saretti, Elena
Biasotti, Giulia
Amella, Roberta
Cotellessa, Filippo
Restivo, Domenico A.
Currà, Antonio
Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title_full Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title_fullStr Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title_full_unstemmed Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title_short Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia
title_sort effectiveness of botulinum toxin on pain in stroke patients suffering from upper limb spastic dystonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780435/
https://www.ncbi.nlm.nih.gov/pubmed/35051017
http://dx.doi.org/10.3390/toxins14010039
work_keys_str_mv AT trompettocarlo effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT marinellilucio effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT morilaura effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT puceluca effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT avantichiara effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT sarettielena effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT biasottigiulia effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT amellaroberta effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT cotellessafilippo effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT restivodomenicoa effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia
AT curraantonio effectivenessofbotulinumtoxinonpaininstrokepatientssufferingfromupperlimbspasticdystonia