Efficacy of botulinum neurotoxin-A in the treatment of neuropsychiatric symptoms in patients with Parkinson's disease: an open-label randomized controlled study.

OBJECTIVES

Parkinson's disease (PD) often presents with neuropsychiatric symptoms that worsen quality of life. The aim of this study was to evaluate the effectiveness of Botulinum neurotoxin-A (BTX-A) in managing neuropsychiatric manifestations in PD patients.

METHODS

Neuropsychiatric status was assessed in 185 PD patients using the Cornell Medical Index (CMI). Ninety-four patients exhibiting neuropsychiatric symptoms were randomly assigned to two groups: BTX-A (n=47, local injections) and citalopram (n=47, 10-40 mg/day). Outcomes were compared at baseline and 8 weeks post-treatment.

RESULTS

The authors findings revealed a significant reduction in somatization, tension, anxiety, depression, sensitivity, and overall scores in the BTX-A group at the eight-week follow-up ( < 0.05 for all). Notably, patients in the BTX-A group exhibited similar levels of somatization, depression, anxiety, maladjustment, sensitivity, anger, and overall scores compared to the citalopram group ( > 0.05 for all). Both groups reported comparable percentages of improvement in neuropsychiatric symptoms (75.6% vs. 82.6%,  = 0.57).

CONCLUSIONS

This study demonstrates the potential of BTX-A in alleviating tension, anxiety, depression, sensitivity, and other neuropsychiatric symptoms in PD patients. Importantly, BTX-A's efficacy was comparable to that of citalopram, suggesting its potential as a viable therapeutic option for managing neuropsychiatric manifestations in PD.