title: Botulinum toxin B ultrasound-guided injections for sialorrhea in amyotrophic lateral sclerosis and Parkinson's disease.
abstract: Sialorrhea is frequent and invalidating in patients with amyotrophic lateral sclerosis (ALS) or Parkinson's disease (PD). Botulinum toxin (BTX) emerged as an alternative to traditional treatments. We evaluated efficacy and tolerability of ultrasound-guided BTX-B injections in parotids and submandibular glands in 18 patients with ALS or PD. At 1 week, both objective (cotton rolls weight) and subjective evaluations (dedicated clinical scales) documented sialorrhea reduction (p<0.01). ALS patients reported shorter benefit duration (p<0.001) and higher prevalence of viscous saliva (seven vs one patients), possibly due to different pattern of autonomic involvement. BTX-B seems efficacious in reducing sialorrhea in ALS and PD but the risk-benefit ratio might differ between these two conditions. This might have implications for clinical practice.
authors.affiliation: Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy. m.f.contarino@amc.uva.nl
authors.forename: Maria Fiorella
authors.initials: MF
authors.lastname: Contarino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Paola
authors.initials: P
authors.lastname: Tittoto
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
authors.forename: Mario
authors.initials: M
authors.lastname: Sabatelli
authors.forename: Augusto
authors.initials: A
authors.lastname: Cedrone
authors.forename: Gian Ludovico
authors.initials: GL
authors.lastname: Rapaccini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Pietro Attilio
authors.initials: PA
authors.lastname: Tonali
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Bentivoglio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*
chemical_list: D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A