Does Ultrasound Guidance Improve the Effectiveness of Neurotoxin Injections in Patients with Cervical Dystonia? (A Prospective, Partially-Blinded, Clinical Study).

Abstract

AIM:

The aim of this study was to evaluate the efficacy of ultrasound guidance (US) in the treatment of cervical dystonia (CD) with botulinum neurotoxin type A (BoNT-A) injections in comparison to anatomical landmarks (AL). To date, US is routinely used in many centers, but others deny its usefulness.

MATERIALS AND METHODS:

Thirty-five patients (12 males, 23 females) with a clinical diagnosis of CD were included in the study. Intramuscular administration of BoNT-A was performed using either US guidance, or with AL, in two separate therapeutic sessions. The efficacy of BoNT-A administration was assessed with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), Tsui modified scale, Craniocervical Dystonia Questionnaire (CDQ-24) and Clinical Global Impression-Improvement scale (CGI-I). Additionally, patients at therapeutic sessions were digitally recorded and evaluated by two blinded and independent raters.

RESULTS:

A significant decrease in total TWSTRS, severity subscale TWSTRS, Tsui score, and CDQ-24 was found in both the AL and US group; however, in the TWSTRS disability and pain subscales, a significant decrease was found only in the US group. Moreover, US guided treatment also resulted in a greater decrease in TWSTRS, Tsui score and CDQ-24 compared to anatomical landmarks use only.

CONCLUSIONS:

US guidance might be helpful in improving the results of BoNT-A injections in cervical dystonia, reducing associated pain and disability; however, more studies are needed to evaluate its clinical efficacy.

• Authors: Małgorzata Tyślerowicz, Jarosław Dulski, Justyna Gawryluk, Jarosław Sławek
• Journal: Toxins (Toxins (Basel)) Vol. 14 Issue 10 (09 28 2022) ISSN: 2072-6651 [Electronic] Switzerland
• PMID: 36287943 (Publication Type: Journal Article)

Chemical References

• Botulinum Toxins, Type A
• Neuromuscular Agents
• Neurotoxins

Topics

• Male
• Female
• Humans
• Torticollis (diagnostic imaging, drug therapy)
• Botulinum Toxins, Type A (therapeutic use)
• Neuromuscular Agents (therapeutic use)
• Neurotoxins (therapeutic use)
• Prospective Studies
• Treatment Outcome
• Pain (drug therapy)