Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study

Introduction: Botulinumtoxin associated muscle denervation (BNTMD) can be detected by magnet resonance imaging (MRI), MRI may provide further insights into the exact timeline of BNTMD and the potential impact and timing of physical exercise. We aimed to assess the time interval until detection of BN...

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Autores principales:	Stefan Macher, Ewald Unger, Martin Zalaudek, Michael Weber, Gottfried Kranz, Georg Kranz, Gregor Kasprian, Thomas Sycha
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	botulinumtoxin denervation signs magnetic resonance imaging (MRI) dynamometry muscle denervation Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3ea9a9096ed74cecade618cced14855f
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spelling	oai:doaj.org-article:3ea9a9096ed74cecade618cced14855f2021-11-19T07:54:10ZDenervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study1664-229510.3389/fneur.2021.719030https://doaj.org/article/3ea9a9096ed74cecade618cced14855f2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.719030/fullhttps://doaj.org/toc/1664-2295Introduction: Botulinumtoxin associated muscle denervation (BNTMD) can be detected by magnet resonance imaging (MRI), MRI may provide further insights into the exact timeline of BNTMD and the potential impact and timing of physical exercise. We aimed to assess the time interval until detection of BNTMD by MRI and whether immediate physical exercise after intramuscular BNT injection has a measurable effect on clinical parameters and the intramuscular denervation dynamics illustrated by MRI.Materials and Methods: Eleven age-matched patients were randomized to an “exercise” or “no-exercise” group. Eighty mouse-units of incobotulinumtoxin were injected into the spastic biceps muscle. MRI of the injected region, hand-held dynamometry of elbow flexor strength and clinical rating scales (mAS, CGI-I) were conducted in predefined intervals.Results: We could not detect BNTMD within 24 h but 7 days after injection independent of group allocation (exercise n = 6, no-exercise n = 5). Denervation signs were more diffuse and spread into adjacent muscles in patients having received exercise. We could not detect differences concerning clinical measures between the two groups.Conclusions: Physical exercise might influence BNTMD dynamics and promote propagation of T2-MR muscle denervation signs from the injected site into adjacent muscles.Trial registration:clinicaltrialsregister.eu, Identifier 2017-003117-25.Stefan MacherEwald UngerMartin ZalaudekMichael WeberGottfried KranzGeorg KranzGeorg KranzGeorg KranzGregor KasprianThomas SychaFrontiers Media S.A.articlebotulinumtoxindenervation signsmagnetic resonance imaging (MRI)dynamometrymuscle denervationNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	botulinumtoxin denervation signs magnetic resonance imaging (MRI) dynamometry muscle denervation Neurology. Diseases of the nervous system RC346-429
spellingShingle	botulinumtoxin denervation signs magnetic resonance imaging (MRI) dynamometry muscle denervation Neurology. Diseases of the nervous system RC346-429 Stefan Macher Ewald Unger Martin Zalaudek Michael Weber Gottfried Kranz Georg Kranz Georg Kranz Georg Kranz Gregor Kasprian Thomas Sycha Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
description	Introduction: Botulinumtoxin associated muscle denervation (BNTMD) can be detected by magnet resonance imaging (MRI), MRI may provide further insights into the exact timeline of BNTMD and the potential impact and timing of physical exercise. We aimed to assess the time interval until detection of BNTMD by MRI and whether immediate physical exercise after intramuscular BNT injection has a measurable effect on clinical parameters and the intramuscular denervation dynamics illustrated by MRI.Materials and Methods: Eleven age-matched patients were randomized to an “exercise” or “no-exercise” group. Eighty mouse-units of incobotulinumtoxin were injected into the spastic biceps muscle. MRI of the injected region, hand-held dynamometry of elbow flexor strength and clinical rating scales (mAS, CGI-I) were conducted in predefined intervals.Results: We could not detect BNTMD within 24 h but 7 days after injection independent of group allocation (exercise n = 6, no-exercise n = 5). Denervation signs were more diffuse and spread into adjacent muscles in patients having received exercise. We could not detect differences concerning clinical measures between the two groups.Conclusions: Physical exercise might influence BNTMD dynamics and promote propagation of T2-MR muscle denervation signs from the injected site into adjacent muscles.Trial registration:clinicaltrialsregister.eu, Identifier 2017-003117-25.
format	article
author	Stefan Macher Ewald Unger Martin Zalaudek Michael Weber Gottfried Kranz Georg Kranz Georg Kranz Georg Kranz Gregor Kasprian Thomas Sycha
author_facet	Stefan Macher Ewald Unger Martin Zalaudek Michael Weber Gottfried Kranz Georg Kranz Georg Kranz Georg Kranz Gregor Kasprian Thomas Sycha
author_sort	Stefan Macher
title	Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
title_short	Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
title_full	Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
title_fullStr	Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
title_full_unstemmed	Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study
title_sort	denervation dynamics after intramuscular bnt injection in patients with focal spasticity monitored by mri and dynamometry–a blinded randomized controlled pilot study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3ea9a9096ed74cecade618cced14855f
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Denervation Dynamics After Intramuscular BNT Injection in Patients With Focal Spasticity Monitored by MRI and Dynamometry–a Blinded Randomized Controlled Pilot Study

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