UTILITY AND PHYSIOLOGY OF BOTULINUM TOXIN FOR INVOLUNTARY MOVEMENT DISORDERS

我们一直在研究局部注射肉毒杆菌毒素的疗效 (BTX)用于治疗运动障碍，包括肌张力障碍，以及 震颤。当小剂量直接注射到肌肉中时，肉毒杆菌 毒素被吸收到神经肌肉处的突触前神经元 连接处，防止乙酰胆碱的释放。异常肌肉 收缩减少，功能改善。肉毒杆菌毒素治疗 毒素耐受性好，副作用最小。我们也一直在 用肉毒杆菌毒素研究肌张力障碍的生理学。 我们正在完成一项针对F型BTX患者的BTX试验 对A型抗体的反应。85%的人受益 来自BTX F，与他们之前对A型的反应相似。 没有受益于A型的患者也没有受益于F.A型 一名患者失去反应，但抗体检测为阴性 A型毒素，对F型注射有反应。 超过80%的手部肌张力障碍患者受益于肉毒杆菌毒素 注射。一项关于即刻锻炼效果的研究结果 肉毒杆菌毒素注射后正在进行分析，看看是否运动 增强BTX对活性神经元的摄取，程度有所改善 或福利的期限。 18例震颤患者(手臂震颤10例，头颈部震颤8例) 到目前为止都被治疗过。大约60%的震颤患者有更多 而不是注射BTX带来的微小改善。数据正在收集中 客观评估三轴疗法对震颤的反应 加速度计。

We have been studying the efficacy of local injections of botulinum toxin (btx) for the treatment of movement disorders including dystonia, and tremor. When injected in small doses directly into the muscle, botulinum toxin is taken up into the presynaptic neuron at the neuromuscular junction where it prevents the release of acetylcholine. Abnormal muscle contraction is decreased and function improves. Treatment with botulinum toxin is well-tolerated with minimal side effects. We have also been using botulinum toxin to study the physiology of dystonia. We are completing a trial of btx type F for patients with a loss of response to type A due to antibodies. Eighty-five percent had benefit from btx F which was similar to their previous response to type A. One patient with no benefit from type A also had no benefit from type F. A single patient with loss of response but negative antibody testing for type A toxin, had response to type F injection. Over 80% of patients with hand dystonia benefit from botulinum toxin injection. The results of a study on the effects of exercise immediately after botulinum toxin injection are being analyzed to see if exercise enhances btx uptake into active neurons with improvement in the extent or duration of benefit. Eighteen patients with tremor (arm tremor 10, head/neck tremor 8) have been treated to date. Approximately 60% of the tremor patients have more than minimal improvement with btx injection. Data are being collected to assess objectively tremor response to treatment with triaxial accelerometry.