Department of Neurology, Szent-Györgyi Albert Clinical Centre, Szent-Györgyi Albert Faculty of Medicine, University of Szeged, Szeged.
Ideggyogy Sz. 2023 Jan 30;76(1-2):37-45. doi: 10.18071/isz.76.0037.
Cervical dystonia (CD) is the most common form of focal dystonias, where the identification of the involved muscles, the determination of optimal botulinum neurotoxin A (BoNT-A) dose per muscle injection, and precise targeting may be challenging. The aim of the current study is to compare local centre data with international data, enabling the identification of population and methodological factors behind the differences, thereby further improvement of the care of Hungarian patients with CD.
.The data of all consecutive CD patients, who were injected with BoNT-A at the botulinum neurotoxin outpatient clinic at the Department of Neurology, University of Szeged between 11 August and 21 September 2021, were retrospectively collected and analysed in a cross-sectional manner. The frequency of the involved muscles, determined by the application of the collum-caput (COL-CAP) concept, and the parameters for the BoNT-A formulations, injected via ultrasound (US)-guidance, were calculated and compared with available international data.
.In the current study, 58 patients (19 males and 39 females) were involved with mean age of 58.4 (± SD 13.6, range 24-81) years. The most common subtype was torticaput (29.3%). Tremor affected 24.1% of patients. The most injected muscles were trapezius (56.9% of all cases), followed by the levator scapulae (51.7%), splenius capitis (48.3%), sternocleidomastoid (32.8%), and semispinalis capitis (22.4%). The injected mean doses per patient were 117 ± SD 38.5 (range: 50-180) units for onaBoNT-A, 118 ± SD 29.8 (range: 80-180) units for incoBoNT-A, and 405 ± SD 162 (range: 100-750 units) for aboBoNT-A.
.Although there were several similarities between the results of the current and the multicentre studies, all were carried out using the COL-CAP concept and US-guided BoNT-A injections, authors should pay attention to better distinction of torti-forms and the more frequent injection of especially the obliquus capitis inferior, mainly in cases with no-no tremor.
.颈肌张力障碍（CD）是局灶性肌张力障碍中最常见的一种，在这种疾病中，确定受累肌肉、每块肌肉注射的最佳肉毒毒素 A（BoNT-A）剂量以及精确的靶向可能具有挑战性。本研究的目的是比较本地中心数据与国际数据，以确定人群差异背后的人口统计学和方法学因素，从而进一步改善匈牙利 CD 患者的护理。
.在 2021 年 8 月 11 日至 9 月 21 日期间，我们在塞格德大学神经病学系的肉毒毒素门诊对所有连续接受 BoNT-A 注射的 CD 患者进行了回顾性横断面研究。应用 collum-caput（COL-CAP）概念确定受累肌肉的频率，并根据超声（US）引导下注射的 BoNT-A 制剂参数进行计算，并与可用的国际数据进行比较。
.在本研究中，共有 58 名患者（19 名男性和 39 名女性）参与，平均年龄为 58.4（±SD 13.6，范围 24-81）岁。最常见的亚型是 torticaput（29.3%）。震颤影响了 24.1%的患者。最常注射的肌肉是斜方肌（56.9%的病例），其次是肩胛提肌（51.7%）、头夹肌（48.3%）、胸锁乳突肌（32.8%）和头半棘肌（22.4%）。每位患者的平均注射剂量为 onaBoNT-A 为 117 ± SD 38.5（范围：50-180）单位，incoBoNT-A 为 118 ± SD 29.8（范围：80-180）单位，aboBoNT-A 为 405 ± SD 162（范围：100-750 单位）。
.尽管当前和多中心研究的结果存在一些相似之处，但两者均采用 COL-CAP 概念和 US 引导下的 BoNT-A 注射进行，作者应注意更好地区分 torti-forms，并更频繁地注射特别是下斜方肌，主要针对无震颤的病例。
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