Adler Charles H, Bansberg Stephen F, Hentz Joseph G, Ramig Lorraine O, Buder Eugene H, Witt Kristi, Edwards Brian W, Krein-Jones Kari, Caviness John N
Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic Scottsdale, 13400 E. Shea Boulevard, Scottsdale, AZ 85259, USA.
Arch Neurol. 2004 Sep;61(9):1416-20. doi: 10.1001/archneur.61.9.1416.
Voice tremor, like spasmodic dysphonia and other tremor disorders, may respond to botulinum toxin type A injections.
To evaluate the safety and efficacy of botulinum toxin type A injections as treatment for voice tremor.
A randomized study of 3 doses of botulinum toxin type A with 6 weeks of follow-up.
A single-site tertiary care center.
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.
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.
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.
Voice tremor improves following injections of botulinum toxin type A.
声音震颤，如痉挛性发声障碍和其他震颤疾病，可能对A型肉毒毒素注射有反应。
评估A型肉毒毒素注射治疗声音震颤的安全性和有效性。
一项对3种剂量A型肉毒毒素进行6周随访的随机研究。
一个单中心三级医疗中心。
13名声音震颤患者（11名女性，2名男性；平均年龄73岁），无痉挛性发声障碍或头部、口腔、颌部或面部震颤，纳入本研究。患者每侧声带接受1.25单位（n = 5）、2.5单位（n = 5）或3.75单位（n = 3）的A型肉毒毒素注射。所有患者在基线时以及注射后第2、4和6周进行评估。
主要结局指标为患者震颤评定量表，次要指标包括患者评定的功能障碍、反应评定量表、独立随机震颤评定以及声学指标。
所有剂量水平的所有患者均指出注射有效果。起效的平均时间为2.3天（范围1 - 7天）。对于所有患者而言，平均震颤严重程度量表评分（患者按5分制评分）在第2周改善1.4分，第4周改善1.6分，第6周改善1.7分。功能障碍指标、注射效果指标、录像语音的独立评定以及震颤的声学指标也显示有改善。所有剂量下的主要不良反应为声音粗糙和吞咽困难。
注射A型肉毒毒素后声音震颤有所改善。
