Personalized Bilateral Upper Limb Essential Tremor Therapy with Botulinum Toxin Using Kinematics.
In: Toxins, Jg. 11 (2019-02-19), Heft 2
academicJournal
Zugriff:
Variability of multi-joint essential tremor (ET) between patients and within the two upper limbs makes a visual assessment for the determination of botulinum toxin type A (BoNT-A) injections challenging. Kinematic tremor analysis guidance has succeeded in overcoming this challenge by making effective long-term unilateral BoNT-A injections for disabling ET. In this open-label study, 31 ET participants received three bilateral arm BoNT-A injection cycles over 30 weeks with follow-ups six-weeks post-treatment. Whole-arm kinematic assessment of tremor using a customized, automated algorithm provided muscle selection and dosing per muscle without clinician's assessment. Efficacy endpoints included Fahn-Tolosa-Marin tremor scale, quality of life (QoL) questionnaire, and maximum grip strength. BoNT-A reduced tremor amplitude by 47.7% in both the arms at week-6 ( p < 0.005) that persisted from weeks 18⁻30. QoL was improved by 26.5% ( p < 0.005) over the treatment period. Functional interference due to tremor was reduced by 30% ( p < 0.005) from weeks 6⁻30. Maximum grip strength was reduced at week 6 ( p = 0.001) but was not functionally impaired for the participants. Effective bilateral ET therapy by personalized BoNT-A injections could be achieved using computer-assisted tremor analysis. By removing variability inherent within the clinical assessments, this standardized tremor analysis method enabled patients to have improved bimanual upper limb functionality after the first treatment.
Titel: |
Personalized Bilateral Upper Limb Essential Tremor Therapy with Botulinum Toxin Using Kinematics.
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Autor/in / Beteiligte Person: | Samotus, O ; Lee, J ; Jog, M |
Zeitschrift: | Toxins, Jg. 11 (2019-02-19), Heft 2 |
Veröffentlichung: | Basel : MDPI, 2019 |
Medientyp: | academicJournal |
ISSN: | 2072-6651 (electronic) |
DOI: | 10.3390/toxins11020125 |
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