Botulinum toxin type-A treatment in spastic paraparesis

A neurophysiological study

Flavia Pauri, Laura Boffa, Emanuele Cassetta, Patrizio Pasqualetti, Paolo Maria Rossini

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: The aim of this study was to verify the action of Botulinum toxin type-A (BoNT-A) by means of neurophysiological techniques, in patients presenting lower limb spasticity and requiring BoNT-A injections in the calf muscles, due to the poor response to medical antispastic treatment. Subjects and method: Patients presenting paraparesis were enrolled. They underwent clinical evaluation for spasticity according to the Ashworth scale and neurophysiological recordings including: motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the leg area; compound motor action potential (cMAP) to tibial nerve stimulation, F-wave, and H-reflex before the treatment and 24 h, 2 weeks and 1 month after the injection of BoNT-A. In all patients, gastrocnemius was treated and in some cases soleus or tibialis posterior muscles were also injected. Results: In all patients, BoNT-A injections induced a clear clinical improvement as showed by the reduced spasticity values of the Ashworth scale. A significant increment of MEP latency and central conduction time (CCT) duration were observed 2 weeks after the treatment only in the injected muscles. Conclusions: Prolonged MEP latencies and CCT after BoNT-A injections is probably due to a central alteration in responsiveness of spinal motor neurons to descending impulses from the corticospinal tracts. Such changes represent objective parameters heralding clinical efficacy of treatment. (C) 2000 Elsevier Science B.V.

Original languageEnglish
Pages (from-to)89-97
Number of pages9
JournalJournal of the Neurological Sciences
Volume181
Issue number1-2
DOIs
Publication statusPublished - Dec 1 2000

Fingerprint

Spastic Paraparesis
Type A Botulinum Toxins
Motor Evoked Potentials
Injections
Muscles
Paraparesis
H-Reflex
Tibial Nerve
Pyramidal Tracts
Transcranial Magnetic Stimulation
Motor Neurons
Therapeutics
Action Potentials
Lower Extremity
Leg

Keywords

  • Botulinum toxin therapy
  • Spasticity
  • TMS

ASJC Scopus subject areas

  • Ageing
  • Clinical Neurology
  • Surgery
  • Developmental Neuroscience
  • Neurology
  • Neuroscience(all)

Cite this

Botulinum toxin type-A treatment in spastic paraparesis : A neurophysiological study. / Pauri, Flavia; Boffa, Laura; Cassetta, Emanuele; Pasqualetti, Patrizio; Rossini, Paolo Maria.

In: Journal of the Neurological Sciences, Vol. 181, No. 1-2, 01.12.2000, p. 89-97.

Research output: Contribution to journalArticle

Pauri, Flavia ; Boffa, Laura ; Cassetta, Emanuele ; Pasqualetti, Patrizio ; Rossini, Paolo Maria. / Botulinum toxin type-A treatment in spastic paraparesis : A neurophysiological study. In: Journal of the Neurological Sciences. 2000 ; Vol. 181, No. 1-2. pp. 89-97.
@article{0642aab998c245d2b865b776cf066499,
title = "Botulinum toxin type-A treatment in spastic paraparesis: A neurophysiological study",
abstract = "Objective: The aim of this study was to verify the action of Botulinum toxin type-A (BoNT-A) by means of neurophysiological techniques, in patients presenting lower limb spasticity and requiring BoNT-A injections in the calf muscles, due to the poor response to medical antispastic treatment. Subjects and method: Patients presenting paraparesis were enrolled. They underwent clinical evaluation for spasticity according to the Ashworth scale and neurophysiological recordings including: motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the leg area; compound motor action potential (cMAP) to tibial nerve stimulation, F-wave, and H-reflex before the treatment and 24 h, 2 weeks and 1 month after the injection of BoNT-A. In all patients, gastrocnemius was treated and in some cases soleus or tibialis posterior muscles were also injected. Results: In all patients, BoNT-A injections induced a clear clinical improvement as showed by the reduced spasticity values of the Ashworth scale. A significant increment of MEP latency and central conduction time (CCT) duration were observed 2 weeks after the treatment only in the injected muscles. Conclusions: Prolonged MEP latencies and CCT after BoNT-A injections is probably due to a central alteration in responsiveness of spinal motor neurons to descending impulses from the corticospinal tracts. Such changes represent objective parameters heralding clinical efficacy of treatment. (C) 2000 Elsevier Science B.V.",
keywords = "Botulinum toxin therapy, Spasticity, TMS",
author = "Flavia Pauri and Laura Boffa and Emanuele Cassetta and Patrizio Pasqualetti and Rossini, {Paolo Maria}",
year = "2000",
month = "12",
day = "1",
doi = "10.1016/S0022-510X(00)00439-1",
language = "English",
volume = "181",
pages = "89--97",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",
number = "1-2",

}

TY - JOUR

T1 - Botulinum toxin type-A treatment in spastic paraparesis

T2 - A neurophysiological study

AU - Pauri, Flavia

AU - Boffa, Laura

AU - Cassetta, Emanuele

AU - Pasqualetti, Patrizio

AU - Rossini, Paolo Maria

PY - 2000/12/1

Y1 - 2000/12/1

N2 - Objective: The aim of this study was to verify the action of Botulinum toxin type-A (BoNT-A) by means of neurophysiological techniques, in patients presenting lower limb spasticity and requiring BoNT-A injections in the calf muscles, due to the poor response to medical antispastic treatment. Subjects and method: Patients presenting paraparesis were enrolled. They underwent clinical evaluation for spasticity according to the Ashworth scale and neurophysiological recordings including: motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the leg area; compound motor action potential (cMAP) to tibial nerve stimulation, F-wave, and H-reflex before the treatment and 24 h, 2 weeks and 1 month after the injection of BoNT-A. In all patients, gastrocnemius was treated and in some cases soleus or tibialis posterior muscles were also injected. Results: In all patients, BoNT-A injections induced a clear clinical improvement as showed by the reduced spasticity values of the Ashworth scale. A significant increment of MEP latency and central conduction time (CCT) duration were observed 2 weeks after the treatment only in the injected muscles. Conclusions: Prolonged MEP latencies and CCT after BoNT-A injections is probably due to a central alteration in responsiveness of spinal motor neurons to descending impulses from the corticospinal tracts. Such changes represent objective parameters heralding clinical efficacy of treatment. (C) 2000 Elsevier Science B.V.

AB - Objective: The aim of this study was to verify the action of Botulinum toxin type-A (BoNT-A) by means of neurophysiological techniques, in patients presenting lower limb spasticity and requiring BoNT-A injections in the calf muscles, due to the poor response to medical antispastic treatment. Subjects and method: Patients presenting paraparesis were enrolled. They underwent clinical evaluation for spasticity according to the Ashworth scale and neurophysiological recordings including: motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the leg area; compound motor action potential (cMAP) to tibial nerve stimulation, F-wave, and H-reflex before the treatment and 24 h, 2 weeks and 1 month after the injection of BoNT-A. In all patients, gastrocnemius was treated and in some cases soleus or tibialis posterior muscles were also injected. Results: In all patients, BoNT-A injections induced a clear clinical improvement as showed by the reduced spasticity values of the Ashworth scale. A significant increment of MEP latency and central conduction time (CCT) duration were observed 2 weeks after the treatment only in the injected muscles. Conclusions: Prolonged MEP latencies and CCT after BoNT-A injections is probably due to a central alteration in responsiveness of spinal motor neurons to descending impulses from the corticospinal tracts. Such changes represent objective parameters heralding clinical efficacy of treatment. (C) 2000 Elsevier Science B.V.

KW - Botulinum toxin therapy

KW - Spasticity

KW - TMS

UR - http://www.scopus.com/inward/record.url?scp=0034548737&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034548737&partnerID=8YFLogxK

U2 - 10.1016/S0022-510X(00)00439-1

DO - 10.1016/S0022-510X(00)00439-1

M3 - Article

VL - 181

SP - 89

EP - 97

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

IS - 1-2

ER -