Department of Neurology, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
Toxins (Basel). 2021 Jul 16;13(7):493. doi: 10.3390/toxins13070493.
This study analyses the influence of the course of the disease of idiopathic cervical dystonia (CD) before botulinum toxin (BoNT) therapy on long-term outcomes. 74 CD-patients who were treated on a regular basis in the botulinum toxin outpatient department of the University of Düsseldorf and had received at least 3 injections were consecutively recruited after written informed consent. Patients were asked to rate the amount of change of CD in relation to the severity of CD at begin of BoNT therapy (IMPQ). Then they had to draw the course of disease of CD from onset of symptoms until initiation of BoNT therapy (CoDB-graph) on a sheet of paper into a square of 10 × 10 cm size. Remaining severity of CD was estimated by the treating physician using the TSUI-score. Demographical and treatment related data were extracted from the charts of the patients. Depending on the curvature four different types of CoDB-graphs could be distinguished. Time to BoNT therapy, increase of dose and improvement during BoNT treatment were significantly ( < 0.05) different when patients were split up according to CoDB-graph types. The lower the age at onset of symptoms, the shorter was the time to therapy ( < 0.02). Initial dose ( < 0.04) and actual dose ( < 0.009) were negatively correlated with the age of the patients at recruitment. The course of disease of CD before BoNT therapy has influence on long-term outcome. This has implications on patient management and information on the efficacy of BoNT treatment.
本研究分析了特发性颈肌张力障碍（CD）患者在接受肉毒毒素（BoNT）治疗前疾病进程对长期疗效的影响。 74 名 CD 患者在杜塞尔多夫大学 BoNT 门诊接受常规治疗，且至少接受了 3 次注射后，在签署书面知情同意书后连续招募。患者被要求评估与 BoNT 治疗开始时 CD 严重程度相关的 CD 变化量（IMPQ）。然后，他们必须在一张 10×10cm 大小的纸上根据症状开始到 BoNT 治疗开始的疾病进程（CoDB-graph）绘制一个正方形。CD 的剩余严重程度由治疗医生使用 TSUI 评分进行估计。从患者图表中提取人口统计学和治疗相关数据。根据曲线的曲率，可以将 CoDB-graph 分为四种不同类型。根据 CoDB-graph 类型将患者分组后，BoNT 治疗的时间、剂量增加和治疗期间的改善均有显著差异（<0.05）。症状发作的年龄越小，治疗时间越短（<0.02）。初始剂量（<0.04）和实际剂量（<0.009）与招募时患者的年龄呈负相关。BoNT 治疗前 CD 的病程对长期疗效有影响。这对患者管理和 BoNT 治疗效果的信息具有重要意义。
