Botulinum toxin type A for treating voice tremor
Botulinum toxin type A for treating voice tremor
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DOI：
10.1001/archneur.61.9.1416
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Caviness, JN
中科院分区：
文献类型：
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作者：
Adler, CH;Bansberg, SF;Caviness, JN
背景：像痉挛性发声障碍和其他震颤性疾病一样，声音震颤可能对A型肉毒杆菌毒素注射有反应。目的：评价A型肉毒毒素注射治疗声音震颤的安全性和有效性。设计：3种剂量A型肉毒毒素的随机研究，随访6周。设置：一个单一的三级护理中心。参与者和方法：13名受试者（11名女性，2名男性;平均年龄，73岁），有声音震颤，没有痉挛性发音困难或头、嘴、颌或面部震颤。患者在每条声带中接受1.25 U（n = 5）、2.5 U（n = 5）或3.75 U（n = 3）的A型肉毒杆菌毒素。所有患者在基线和注射后第2、4和6周进行评价。主要结果指标：主要结果指标是患者震颤评定量表，次要指标包括患者评定的功能障碍、反应评定量表、独立随机震颤评定和声学测量。至起效的平均时间为2.3天（范围：1-7天）。对于所有合并的患者，平均震颤严重程度量表评分（由患者在5分量表上评定）在第2周改善1.4分，在第4周改善1.6分，在第6周改善1.7分。功能障碍的措施，注射效果的措施，独立的录像讲话的评级，和震颤的声学措施也显示出改善。所有剂量的主要不良反应是呼吸困难和吞咽困难。结论：注射A型肉毒毒素后，声音震颤得到改善。
Background: Voice tremor, like spasmodic dysphonia and other tremor disorders, may respond to botulinum toxin type A injections. Objective: To evaluate the safety and efficacy of botulinum toxin type A injections as treatment for voice tremor.Design: A randomized study of 3 doses of botulinum toxin type A with 6 weeks of follow-up.Setting: A single-site tertiary care center.Participants and Methods: Thirteen subjects (11 women, 2 men; mean age, 73 years) with voice tremor and no spasmodic dysphonia or head, mouth, jaw, or facial tremor were entered into this study. Patients received 1.25 U (n = 5), 2.5 U (n = 5), or 3.75 U (n = 3) of botulinum toxin type A in each vocal cord. All patients were evaluated at baseline and postinjection at weeks 2, 4, and 6.Main Outcome Measures: The primary outcome measure was the patient tremor rating scale, with secondary measures including patient-rated functional disability, response rating scale, independent randomized tremor ratings, and acoustical measures.Results: All patients at all dose levels noted an effect from the injection. The mean time to onset of effect was 2.3 days (range, 1-7 days). For all patients combined, mean tremor severity scale scores (rated by patients on a 5-point scale) improved 1.4 points at week 2, 1.6 points at week 4, and 1.7 points at week 6. Measures of functional disability, measures of the effect of injection, independent ratings of videotaped speech, and acoustic measures of tremor also showed improvement. The main adverse effects at all doses were breathiness and dysphagia.Conclusion: Voice tremor improves following injections of botulinum toxin type A.