Botulinum toxin in upper limb spasticity: study of reciprocal inhibition between forearm muscles.
To establish whether botulinum A toxin (BTX-A) acts on modifying reciprocal inhibition between forearm muscles in spasticity, 20 patients with post-stroke upper limb spasticity lasting for more than 1 year were studied. Clinical examination, physiotherapeutic evaluation, standardized video-tape assessment and electrophysiological testing (flexor carpi radialis muscle M and H responses with study of reciprocal inhibition) were performed at baseline and 2 weeks, 1, 2, 3, 4 months after BTX-A treatment. BTX-A induced a significant decrease of tone and an improvement of motility and functional status, with a significant decrease of the M wave and the H reflex. The reduction in both inhibitory phases of reciprocal inhibition did not change after BTX-A treatment differently from that reported in upper limb dystonia. These findings indicate that the efficacy of BTX-A in upper limb spasticity is mainly due to peripheral effects.
Girlanda
P
P
Clinica Neurologica 2, Policlinico Universitario, Messina, Italy.
Quartarone
A
A
Sinicropi
S
S
Nicolosi
C
C
Roberto
M L
ML
Picciolo
G
G
Macaione
V
V
Battaglia
F
F
Ruggeri
M
M
Messina
C
C
D000368:Aged; D000704:Analysis of Variance; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications*; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D014743:Videotape Recording
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A