Botulinum toxin in essential hand tremor - A randomized double-blind placebo-controlled study with customized injection approach.

Abstract

INTRODUCTION:

To evaluate the safety and efficacy of incobotulinumtoxinA (IncoA) injection for treatment of essential hand tremor. In essential tremor and Parkinson's disease tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor but a high percentage of patients (30-70%) develop moderate to severe hand weakness which has limited its use in clinical practice.

METHODS:

This study was performed from July 2013 to July 2016 on 33 subjects. This is a double-blind, placebo-controlled, crossover trial injecting 80-120 units of IncoA into 8-14 hand and forearm muscles using a customized approach. The subjects were followed for 28 weeks. The treatment efficacy was evaluated by the Fahn Tolosa Marin tremor rating score and NIH genetic criteria for tremor severity at 4 and 8 weeks after each of the two sets of treatments. Hand strength was assessed by an ergometer.

RESULTS:

There was statistically significant improvement in clinical rating score of tremor at 4 and 8 weeks following the IncoA injection.

CONCLUSION:

In this study, injection of IncoA treatment via a customized approach improved essential tremor on the clinical scales and patient's perception with a low occurrence of significant hand weakness.

• Authors: Shivam Om Mittal, Duarte Machado, Diana Richardson, Divyanshu Dubey, Bahman Jabbari
• Journal: Parkinsonism & related disorders (Parkinsonism Relat Disord) Vol. 56 Pg. 65-69 (11 2018) ISSN: 1873-5126 [Electronic] England
• PMID: 29929813 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A
• incobotulinumtoxinA

Topics

• Adult
• Aged
• Aged, 80 and over
• Botulinum Toxins, Type A (administration & dosage)
• Cross-Over Studies
• Double-Blind Method
• Essential Tremor (diagnosis, drug therapy, physiopathology)
• Female
• Hand (innervation, physiopathology)
• Humans
• Male
• Middle Aged
• Neuromuscular Agents (administration & dosage)
• Treatment Outcome