使用B型肉毒毒素治疗上肢痉挛。

Treatment with botulinum toxin type B for upper-limb spasticity.

作者信息

Brashear Allison, McAfee Anita L, Kuhn Elizabeth R, Ambrosius Walter T

机构信息

Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA.

出版信息

Arch Phys Med Rehabil. 2003 Jan;84(1):103-7. doi: 10.1053/apmr.2003.50070.

DOI:10.1053/apmr.2003.50070

PMID:12589629

Abstract

OBJECTIVE

To determine if botulinum toxin type B (MyoBloc) decreases spasticity.

DESIGN

Investigator-initiated trial, open-label, single-treatment session.

SETTING

Single site.

PARTICIPANTS

Ten patients with stable upper-limb spasticity and an Ashworth Scale score of 2 or higher at the elbow, wrist, and fingers.

INTERVENTIONS

Total dose of 10,000U of botulinum toxin type B injected into 5 major muscles.

MAIN OUTCOME MEASURES

The Ashworth Scale, goniometry, and functional assessments were performed at injection and weeks 4, 8, and 12. The principal investigator (PI) global assessment of change (GAC) and the patient GAC were done at weeks 4, 8, and 12 postinjection. The safety of the procedure was measured by adverse events and vital signs.

RESULTS

Improvements in Ashworth Scale scores were observed at weeks 4, 8, and 12 postinjection. At week 4, the mean changes (in Ashworth score) were elbow, -1.0 (P=.016); wrist, -1.7 (P=.004); finger, -1.35 (P=.02); at week 8: elbow, -.83 (P=.016); wrist, -1.00 (P=.016); finger, -.94 (P=.08); and at week 12: elbow, -.61 (P=.07); wrist, -1.00 (P=.016); and finger, -.89 (P=.10). The PI GAC improved at all visits. Nine of the 10 subjects reported dry mouth at week 4, with resolution by week 12. No changes were seen on the functional measures.

CONCLUSIONS

Botulinum toxin type B may be useful in treatment of spasticity.

摘要

目的

确定B型肉毒毒素（MyoBloc）是否能减轻痉挛。

设计

研究者发起的试验，开放标签，单次治疗。

地点

单一研究点。

参与者

10例上肢痉挛稳定且肘部、腕部和手指的Ashworth量表评分达到2级或更高的患者。

干预措施

将10000U的B型肉毒毒素注射到5块主要肌肉中。

主要观察指标

在注射时以及第4、8和12周进行Ashworth量表评估、角度测量和功能评估。在注射后第4、8和12周进行主要研究者（PI）的整体变化评估（GAC）和患者GAC。通过不良事件和生命体征来衡量该治疗程序的安全性。

结果

注射后第4、8和12周观察到Ashworth量表评分有所改善。在第4周，（Ashworth评分的）平均变化为：肘部，-1.0（P = 0.016）；腕部，-1.7（P = 0.004）；手指，-1.35（P = 0.02）；在第8周：肘部，-0.83（P = 0.016）；腕部，-1.00（P = 0.016）；手指，-0.94（P = 0.08）；在第12周：肘部，-0.61（P = 0.）；腕部，-1.00（P = 0.016）；手指，-0.89（P = 0.10）。PI GAC在所有访视时均有改善。10名受试者中有9名在第4周报告口干，至第12周症状缓解。功能测量方面未见变化。