Secondary nonresponsiveness to botulinum toxin A in cervical dystonia: the role of electromyogram-guided injections, botulinum toxin A antibody assay, and the extensor digitorum brevis test.
Identifieur interne : 002B39 ( PubMed/Curation ); précédent : 002B38; suivant : 002B40Secondary nonresponsiveness to botulinum toxin A in cervical dystonia: the role of electromyogram-guided injections, botulinum toxin A antibody assay, and the extensor digitorum brevis test.
Auteurs : Carla Cordivari [Royaume-Uni] ; Vijay Peter Misra ; Angela Vincent ; Santiago Catania ; Kailash P. Bhatia ; Andrew John LeesSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2006.
English descriptors
- KwdEn :
- Action Potentials (drug effects), Antibodies, Blocking (blood), Botulinum Toxins, Type A (administration & dosage), Botulinum Toxins, Type A (immunology), Drug Resistance, Electric Stimulation, Electromyography (drug effects), Humans, Injections, Intramuscular, Muscle, Skeletal (innervation), Retreatment, Torticollis (drug therapy), Torticollis (immunology).
- MESH :
- chemical , administration & dosage : Botulinum Toxins, Type A.
- chemical , blood : Antibodies, Blocking.
- drug effects : Action Potentials, Electromyography.
- drug therapy : Torticollis.
- chemical , immunology : Botulinum Toxins, Type A, Torticollis.
- innervation : Muscle, Skeletal.
- Drug Resistance, Electric Stimulation, Humans, Injections, Intramuscular, Retreatment.
Abstract
We studied 20 patients with cervical dystonia who had started to respond poorly to botulinum toxin A (BTXA) injections after an initial good response. All patients had extensor digitorum brevis (EDB) tests performed in addition to BTXA immunoprecipition assay (IPA) and mouse bioassay (MBA) antibody testing. The patients were reexamined and then treated with carefully placed electromyogram (EMG)-guided BTXA. Nine patients had a good clinical response to EMG-guided injections and all of these patients showed an obvious decrement on the EDB test. All were BTXA blocking antibodies (Abs)-negative via IPA and MBA (apart from one patient who had low BTXA antibodies titers using IPA but no antibodies by MBA). In the other 11 patients, there was a poor clinical response to EMG-guided BTXA injections. Seven of these 11 had small EDB decrement and BTXA antibodies using IPA, suggesting resistance to BTXA. Of the remaining four patients, two had obvious EDB decrement and low antibody titers via IPA (one of them had no antibodies via MBA), while the other two patients showed obvious decrement on the EDB test and no antibodies via IPA. This study shows that the EDB test correlates better with the clinical response than the antibody assays and that EDB decrement does not always correlate quantitatively with the BTXA antibody titers. In patients with secondary nonresponsiveness, it is recommended that an EDB test is the initial investigation of choice. In those patients where the EDB test does not demonstrate resistance to BTXA, a reexamination of the patients and carefully placed injections under EMG guidance may improve results.
DOI: 10.1002/mds.21051
PubMed: 16874756
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Secondary nonresponsiveness to botulinum toxin A in cervical dystonia: the role of electromyogram-guided injections, botulinum toxin A antibody assay, and the extensor digitorum brevis test.</title><author><name sortKey="Cordivari, Carla" sort="Cordivari, Carla" uniqKey="Cordivari C" first="Carla" last="Cordivari">Carla Cordivari</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom. c.cordivari@ion.ucl.ac.uk</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London</wicri:regionArea></affiliation></author><author><name sortKey="Misra, Vijay Peter" sort="Misra, Vijay Peter" uniqKey="Misra V" first="Vijay Peter" last="Misra">Vijay Peter Misra</name></author><author><name sortKey="Vincent, Angela" sort="Vincent, Angela" uniqKey="Vincent A" first="Angela" last="Vincent">Angela Vincent</name></author><author><name sortKey="Catania, Santiago" sort="Catania, Santiago" uniqKey="Catania S" first="Santiago" last="Catania">Santiago Catania</name></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name></author><author><name sortKey="Lees, Andrew John" sort="Lees, Andrew John" uniqKey="Lees A" first="Andrew John" last="Lees">Andrew John Lees</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="doi">10.1002/mds.21051</idno><idno type="RBID">pubmed:16874756</idno><idno type="pmid">16874756</idno><idno type="wicri:Area/PubMed/Corpus">002B39</idno><idno type="wicri:Area/PubMed/Curation">002B39</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Secondary nonresponsiveness to botulinum toxin A in cervical dystonia: the role of electromyogram-guided injections, botulinum toxin A antibody assay, and the extensor digitorum brevis test.</title><author><name sortKey="Cordivari, Carla" sort="Cordivari, Carla" uniqKey="Cordivari C" first="Carla" last="Cordivari">Carla Cordivari</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom. c.cordivari@ion.ucl.ac.uk</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London</wicri:regionArea></affiliation></author><author><name sortKey="Misra, Vijay Peter" sort="Misra, Vijay Peter" uniqKey="Misra V" first="Vijay Peter" last="Misra">Vijay Peter Misra</name></author><author><name sortKey="Vincent, Angela" sort="Vincent, Angela" uniqKey="Vincent A" first="Angela" last="Vincent">Angela Vincent</name></author><author><name sortKey="Catania, Santiago" sort="Catania, Santiago" uniqKey="Catania S" first="Santiago" last="Catania">Santiago Catania</name></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name></author><author><name sortKey="Lees, Andrew John" sort="Lees, Andrew John" uniqKey="Lees A" first="Andrew John" last="Lees">Andrew John Lees</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Action Potentials (drug effects)</term><term>Antibodies, Blocking (blood)</term><term>Botulinum Toxins, Type A (administration & dosage)</term><term>Botulinum Toxins, Type A (immunology)</term><term>Drug Resistance</term><term>Electric Stimulation</term><term>Electromyography (drug effects)</term><term>Humans</term><term>Injections, Intramuscular</term><term>Muscle, Skeletal (innervation)</term><term>Retreatment</term><term>Torticollis (drug therapy)</term><term>Torticollis (immunology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Botulinum Toxins, Type A</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Blocking</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Action Potentials</term><term>Electromyography</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Torticollis</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Botulinum Toxins, Type A</term><term>Torticollis</term></keywords><keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Muscle, Skeletal</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Drug Resistance</term><term>Electric Stimulation</term><term>Humans</term><term>Injections, Intramuscular</term><term>Retreatment</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We studied 20 patients with cervical dystonia who had started to respond poorly to botulinum toxin A (BTXA) injections after an initial good response. All patients had extensor digitorum brevis (EDB) tests performed in addition to BTXA immunoprecipition assay (IPA) and mouse bioassay (MBA) antibody testing. The patients were reexamined and then treated with carefully placed electromyogram (EMG)-guided BTXA. Nine patients had a good clinical response to EMG-guided injections and all of these patients showed an obvious decrement on the EDB test. All were BTXA blocking antibodies (Abs)-negative via IPA and MBA (apart from one patient who had low BTXA antibodies titers using IPA but no antibodies by MBA). In the other 11 patients, there was a poor clinical response to EMG-guided BTXA injections. Seven of these 11 had small EDB decrement and BTXA antibodies using IPA, suggesting resistance to BTXA. Of the remaining four patients, two had obvious EDB decrement and low antibody titers via IPA (one of them had no antibodies via MBA), while the other two patients showed obvious decrement on the EDB test and no antibodies via IPA. This study shows that the EDB test correlates better with the clinical response than the antibody assays and that EDB decrement does not always correlate quantitatively with the BTXA antibody titers. In patients with secondary nonresponsiveness, it is recommended that an EDB test is the initial investigation of choice. In those patients where the EDB test does not demonstrate resistance to BTXA, a reexamination of the patients and carefully placed injections under EMG guidance may improve results.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">16874756</PMID><DateCreated><Year>2006</Year><Month>10</Month><Day>26</Day></DateCreated><DateCompleted><Year>2007</Year><Month>02</Month><Day>02</Day></DateCompleted><DateRevised><Year>2010</Year><Month>11</Month><Day>18</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>21</Volume><Issue>10</Issue><PubDate><Year>2006</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Secondary nonresponsiveness to botulinum toxin A in cervical dystonia: the role of electromyogram-guided injections, botulinum toxin A antibody assay, and the extensor digitorum brevis test.</ArticleTitle><Pagination><MedlinePgn>1737-41</MedlinePgn></Pagination><Abstract><AbstractText>We studied 20 patients with cervical dystonia who had started to respond poorly to botulinum toxin A (BTXA) injections after an initial good response. All patients had extensor digitorum brevis (EDB) tests performed in addition to BTXA immunoprecipition assay (IPA) and mouse bioassay (MBA) antibody testing. The patients were reexamined and then treated with carefully placed electromyogram (EMG)-guided BTXA. Nine patients had a good clinical response to EMG-guided injections and all of these patients showed an obvious decrement on the EDB test. All were BTXA blocking antibodies (Abs)-negative via IPA and MBA (apart from one patient who had low BTXA antibodies titers using IPA but no antibodies by MBA). In the other 11 patients, there was a poor clinical response to EMG-guided BTXA injections. Seven of these 11 had small EDB decrement and BTXA antibodies using IPA, suggesting resistance to BTXA. Of the remaining four patients, two had obvious EDB decrement and low antibody titers via IPA (one of them had no antibodies via MBA), while the other two patients showed obvious decrement on the EDB test and no antibodies via IPA. This study shows that the EDB test correlates better with the clinical response than the antibody assays and that EDB decrement does not always correlate quantitatively with the BTXA antibody titers. In patients with secondary nonresponsiveness, it is recommended that an EDB test is the initial investigation of choice. In those patients where the EDB test does not demonstrate resistance to BTXA, a reexamination of the patients and carefully placed injections under EMG guidance may improve results.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Cordivari</LastName><ForeName>Carla</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom. c.cordivari@ion.ucl.ac.uk</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Misra</LastName><ForeName>Vijay Peter</ForeName><Initials>VP</Initials></Author><Author ValidYN="Y"><LastName>Vincent</LastName><ForeName>Angela</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Catania</LastName><ForeName>Santiago</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Bhatia</LastName><ForeName>Kailash P</ForeName><Initials>KP</Initials></Author><Author ValidYN="Y"><LastName>Lees</LastName><ForeName>Andrew John</ForeName><Initials>AJ</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019138">Antibodies, Blocking</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.24.69</RegistryNumber><NameOfSubstance UI="D019274">Botulinum Toxins, Type A</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000200">Action Potentials</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000187">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019138">Antibodies, Blocking</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000097">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019274">Botulinum Toxins, Type A</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000008">administration & dosage</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000276">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004351">Drug Resistance</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004558">Electric Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004576">Electromyography</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000187">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D007273">Injections, Intramuscular</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018482">Muscle, Skeletal</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000294">innervation</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019233">Retreatment</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014103">Torticollis</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000188">drug therapy</QualifierName><QualifierName MajorTopicYN="N" UI="Q000276">immunology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>7</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2007</Year><Month>2</Month><Day>3</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>7</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.21051</ArticleId><ArticleId IdType="pubmed">16874756</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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