Experimental Biomechanics Group, Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
Toxins (Basel). 2022 Nov 8;14(11):772. doi: 10.3390/toxins14110772.
Spasticity, following the neurological disorder of cerebral palsy (CP), describes a pathological condition, the central feature of which is involuntary and prolonged muscle contraction. The persistent resistance of spastic muscles to stretching is often followed by structural and mechanical changes in musculature. This leads to functional limitations at the respective joint. Focal injection of botulinum toxin type-A (BTX-A) is effectively used to manage spasticity and improve the quality of life of the patients. By blocking acetylcholine release at the neuromuscular junction and causing temporary muscle paralysis, BTX-A aims to reduce spasticity and hereby improve joint function. However, recent studies have indicated some contradictory effects such as increased muscle stiffness or a narrower range of active force production. The potential of these toxin- and atrophy-related alterations in worsening the condition of spastic muscles that are already subjected to changes should be further investigated and quantified. By focusing on the effects of BTX-A on muscle biomechanics and overall function in children with CP, this review deals with which of these goals have been achieved and to what extent, and what can await us in the future.
痉挛是脑瘫（CP）这种神经障碍后的一种病理性状况，其特征为非自愿的、持续的肌肉收缩。痉挛肌肉对拉伸的持续阻力常伴有肌肉结构和力学的改变，从而导致相应关节的功能受限。肉毒毒素 A 型（BTX-A）的局部注射被有效地用于治疗痉挛并提高患者的生活质量。BTX-A 通过阻断神经肌肉接头处的乙酰胆碱释放并导致暂时性肌肉瘫痪，旨在减轻痉挛并改善关节功能。然而，最近的研究表明存在一些矛盾的影响，例如肌肉僵硬增加或主动力产生范围变窄。需要进一步研究和量化这种与毒素和萎缩相关的改变对已经发生变化的痉挛肌肉状况的恶化潜力。本综述重点关注 BTX-A 对 CP 患儿肌肉生物力学和整体功能的影响，探讨已经取得了哪些目标以及在多大程度上取得了这些目标，以及未来可能会有哪些进展。
