The Botulinum Toxins in the Treatment of Cervical Dystonia

Allison Brashear

doi:10.1055/s-2001-13123

Seminars in Neurology, Table of Contents

Semin Neurol 2001; 21(1): 085-090
DOI: 10.1055/s-2001-13123

The Botulinum Toxins in the Treatment of Cervical Dystonia

Allison Brashear

Department of Neurology, Indiana University Medical Center, Indianapolis, Indiana

Abstract

ABSTRACT

The use of botulinum toxin to treat cervical dystonia (CD) has dramatically improved the quality of life of patients with this disabling, often painful disease. Two forms of toxins, botulinum toxin type A (BTX-A) and botulinum toxin type B (BTX-B), have each been studied in large multicenter trials in subjects with CD. A study of BTX-A demonstrated improvement of 5.15 to 10.65 degrees in head position using the Cervical Dystonia Severity Scale (CDSS) in those treated with BTX-A (trade name BOTOX^℗) compared with placebo. A study in patients who continued to respond to BTX-A and a similarly designed study in patients who were resistant to BTX-A demonstrated statistical improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) in those treated with BTX-B (evaluated as NeuroBloc^℗) compared with placebo. The potential availability of both forms of toxin will allow physicians to offer further treatment options to patients with CD.

KEYWORD

Botulinum toxins - clinical trials - cervical dystonia

Full Text

References

REFERENCES

1 Scott A B. Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Opthalmol Soc . 1981; 79 734-770
2 Green P, Fahn S, Diamond B. Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord . 1994; 9 213-217
3 Mezaki T, Kaji R, Hamano T. Optimization of botulinum treatment for cervical and axial dystonias: experience with Japanese type A toxin. J Neurol Neurosurg Psychiatry . 1994; 57 1535-1537
4 American BotB Cervical Dystonia Study Group. American BotB (botulinum toxin type B) in the treatment of cervical dystonia-Protocol AN072-008: an interim analysis [abstract]. Mov Disord . 1995; 10 372
5 Lew M F, Adornato B T, Duane D D. Botulinum toxin type B: a double-blind, placebo-controlled, safety and efficacy study in cervical dystonia. Neurology . 1997; 49 701-707
6 Schiavo G, Benefenati F, Poulain B. Tetanus and botulinum-B neurotoxins block neurotransmitter release by proteolytic cleavage of synaptobrevin. Nature . 1992; 359 832-835
7 DasGupta B R, Sugiyama H. Molecular form of neurotoxins in proteolytic Clostridium botulinum type B cultures. Infect Immunol . 1976; 14 680-686
8 Greene P E, Fahn S. Use of botulinum toxin type F injections to treat torticollis in patients with immunity to botulinum toxin type A. Mov Disord . 1993; 8 479-483
9 Houser M K, Sheean G L, Lees A J. Further studies using higher doses of botulinum toxin type F for torticollis resistant to botulinum toxin type A. J Neurol Neurosurg Psychiatry . 1998; 64 577-580
10 Ludlow C L, Hallett M, Rhew K. Therapeutic use of type F botulinum toxin. N Engl J Med . 1992; 362 349-350
11 Greene P, Fahn S. Treatment of torticollis with injections of botulinum toxin type F in patients with antibodies to botulinum toxin type A [abstract]. Mov Disord . 1992; 7 134
12 Burgen A SV, Dickens F, Zatman L J. The action of botulinum toxin on the neuromuscular junction. J Physiol (Lond) . 1994; 109 10-24
13 DasGupta B R. Structures of botulinum neurotoxin, its functional domains, and perspectives on the crystalline type A toxin. In: Jankovic J, Hallett M, eds. Therapy with Botulinum Toxin New York: Marcel Dekker 1994: 15-39
14 Simpson L L. Kinetic studies on the interaction between botulinum toxin type A and the cholinergic neuromuscular junction. J Pharmacol Exp Ther . 1980; 212 16-21
15 Brin M F. Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Mov Disord . 1997; 6 S146-S168
16 Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: the clinical usefulness of botulinum toxin-A in treating neurologic disorders. Neurology . 1990; 40 1332-1336
17 Jankovic J, Brin M. Botulinum toxin: historical perspective and potential new indications. Mov Disord . 1997; 6 129-144
18 Dendorfer M, Worle B, Breit S. Three-year follow-up on effectiveness and safety of botulinum toxin (BT) in severe axillary hyperhidrosis. WE MOVE International Conference 1999; Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Abstract 2412
19 Schnider P, Moraru E, Voller B. Long-term follow-up after botulinum toxin treatment for palmar and axillary hyperhidrosis. WE MOVE International Conference 1999; Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins. Abstract 3033
20 Mathew N T, Saper J R, Silberstein S D, and the BOTOX℗ Migraine Study Group. A multi-center, double-blind, placebo-controlled trial of two dosages of botulinum toxin type A (BOTOX^℗) in the prophylactic treatment of migraines. Neurology . 1999; 52 A256
21 Fahn S. Concept and classification of dystonia. In: Fahn S, Marsden CD, Calne DB, eds. Dystonia 2 New York: Raven Press 1988: 1-8
22 Elston J S. Botulinum toxin for blepharospasm. In: Jankovic J, Hallett M, eds. Therapy with Botulinum Toxin: American BotB Cervical Dystonia Study Group New York: Marcel Dekker 1994: 191-197
23 Fahn S, List T, Moskowitz C B. Double-blind controlled study of botulinum toxin for blepharospasm [abstract]. Neurology . 1985; 35 271
24 Blitzer A, Brin M, Greene P E, Fahn S. Botulinum toxin injection for the treatment of oromandibular dystonia. Ann Otol Rhinol Laryngol . 1989; 98 93-97
25 Blitzer A, Brin M. Laryngeal dystonia: a series with botulinum toxin therapy. Ann Otol Rhinol Laryngol . 1991; 100 85-89
26 Cohen L G, Hallett M, Geller B D, Hochberg F. Treatment of focal dystonias of the hand with botulinum toxin injections. J Neurol Neurosurg Psychiatry . 1989; 52 355-363
27 Blackie J D, Lees A J. Botulinum toxin treatment in spasmodic torticollis. J Neurol Neurosurg Psychiatry . 1990; 53 640-643
28 Jankovic J, Orman J. Botulinum A toxin for cranial cervical dystonia: a double-blind, placebo-controlled study. Neurology . 1987; 37 616-623
29 Jankovic J, Schwartz K. Botulinum toxin injections for cervical dystonia. Neurology . 1990; 40 277-280
30 Lorentz I T, Subramniam S S, Yiannikas C. Treatment of idiopathic spasmodic torticollis with botulinum toxin A: a double-blind study on twenty-three patients. Mov Disord . 1991; 6 145-150
31 Poewe W, Schelosky L, Kleedorfer B. Treatment of spasmodic torticollis with local injections of botulinum toxin: one year follow-up in 37 patients. J Neurol . 1992; 239 21-25
32 Jahanshahi M, Marion M H, Marsden C D. Natural history of adult-onset idiopathic torticollis. Arch Neurol . 1990; 47 548-552
33 Tsui J, Eisen A, Stoessel A J. Double-blind study of botulinum toxin and spasmodic torticollis. Lancet . 1986; 2 245-246
34 Gelb D J, Lowenstein D H, Aminoff M J. Controlled trial of botulinum toxin injections in treatment of spasmodic torticollis. Neurology . 1989; 39 80-84
35 Boghen D, Flanders M. Effectiveness of botulinum toxin in the treatment of spasmodic torticollis. Eur Neurol . 1993; 33 199-203
36 Moore A P, Blumhardt L D. A double-blind trial of botulinum toxin ``A'' in torticollis with one year follow up. J Neurol Neurosurg Psychiatry . 1991; 54 813-816
37 Green P, Kang U, Fahn S. Double-blind, placebo-controlled trial of botulinum toxin injections for the treatment of spasmodic torticollis. Neurology . 1990; 40 1213-1218
38 Comella C L, Bachman A S, Tanner C M, Brown-Toms N C, Goetz C G. Botulinum toxin injection for spasmodic torticollis: increased magnitude of benefit with electromyographic assistance. Neurology . 1992; 42 878-882
39 Brashear A, Truong B, Charles D. A randomized, double-blind, placebo-controlled study of intramuscular BOTOX^℗ for the treatment of cervical dystonia [abstract]. Mov Disord . 1998; 13 276
40 Brashear A, Cullis P, Moiho E. Cervical Dystonia Severity Scale (CDSS) reliability study [abstract]. Mov Disord . 1998; 13 275
41 Brashear A, Lew M R, Dykstra D D. Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-responsive cervical dystonia. Neurology . 1999; 53 1439-1446
42 Brin M F, Lew M F, Adler C H. Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia. Neurology . 1999; 53 1438-1441
43 Hambleton P, Moore A P. Botulinum neurotoxins: origin, structure, molecular actions, and antibodies. In: Moore P, ed. Handbook of Botulinum Toxin Treatment London: Blackwell Science 1995: 16-27
44 Sakaguchi G. Clostridium botulinum toxins. Pharmacol Ther . 1983; 19 165-194
45 Siegel L S. Evaluation of neutralizing antibodies to type A, B, E, and F botulinum toxins in sera from human recipients of botulinum pentavalent (ABCDE) toxoid. J Clin Microbiol . 1989; 27 1906-1908
46 Schiavo G, Santucci A, DasGupta B R. Botulinum neurotoxins serotypes A and E cleave SNAP-25 at distinct COOH terminal peptide bonds. FEBS Lett . 1993; 335 99-103
47 Schiavo G, Rosetto O, Santucci A. Identification of the nerve terminal targets of botulinum neurotoxin serotype A, serotype D, and serotype E. J Biol Chem . 1993; 268 23784-23787
48 Jankovic J. Treatment of dystonia. In: Watts RL, Koller WC, eds. Movement Disorders: Neurological Principles and Practice New York: McGraw-Hill 1997: 443-454
49 Consky E S, Basinski A, Belle L. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS): assessment of validity and inter-rater reliability [abstract]. Neurology . 1994; 40 445
50 Consky E S, Lang A E. Assessment of cervical dystonia: the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). In: Jankovic J, Hallet M, eds. Therapy with Botulinum Toxin: Neurological Disease and Therapy Series Vol. 25. Koller WC, series ed. New York: Marcel Dekker 1994: 224-226
51 Kaplan E L, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc . 1958; 53 457-481