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Toxins
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Uses of Botulinum Toxin Injection in Medicine
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Uses of Botulinum Toxin Injection in Medicine

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 4631

Special Issue Editor

Dr. Stefano Carda

E-Mail Website
Guest Editor
Department of Clinical Neurosciences, University of Lausanne, CH-1011 Lausanne, Switzerland
Interests: spasticity; botulinum toxin; neurological rehabilitation; gait

Special Issue Information

Dear Colleagues,

In recent decades, we have seen a growing interest in the use of botulinum toxin (mainly type A) in several domains of medicine. From the first utilizations in strabismus and dystonia, the use has widened to spasticity, lower urinary tract dysfunctions, sialorrhea, and headache. Then, to dermatology and cosmesis, pain, achalasia, as well as several gynecological and urological conditions.

The use of botulinum toxin over the years has been so varied that it has led some authors to call it the new panacea. The main reason for this heterogeneous use is mainly due to its principal effect of no cholinergic transmission but also due to its effect on multiple nerve co-transmitters, along with its ease and safety of use.

However, most of the clinical applications of botulinum toxin have a limited level of evidence and are sometimes only limited to case reports.

This Special Issue welcomes original papers or review articles focusing on the different applications that botulinum toxin has in clinical medicine. We seek papers showing the role of botulinum toxin in diagnosis, treatment and/or health maintenance.

We expect to receive papers on traditional and new utilizations of botulinum toxin in cancer medicine, psychiatry, gastrointestinal conditions, musculoskeletal conditions, gynecology and urology. Generalizing, research on all relevant medical conditions in which the use of botulinum toxin has been shown to have potential is welcome.

Dr. Stefano Carda
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxins is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • botulinum toxin
  • therapeutic use
  • clinical medicine
  • diagnostic use of chemicals
  • internal medicine
  • neurology
  • psychiatry
  • physical and rehabilitation medicine
  • palliative medicine
  • reproductive medicine
  • specialties
  • surgical

Published Papers (4 papers)

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Research

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14 pages, 859 KiB  
Article
Longitudinal Assessment of Facial Hyperhidrosis Management: Evaluating the Utility and Quality of Life Improvements following Botulinum Toxin Injection
by Catalin Prodan-Barbulescu, Luca Castiglione, Sonia Roxana Burtic, Marius Murariu, Shruta Reddy, Ovidiu Rosca, Felix Bratosin, Camelia Melania Fizedean, Pavel Krupyshev and Ileana Enatescu
Toxins 2024, 16(1), 59; https://doi.org/10.3390/toxins16010059 - 21 Jan 2024
Cited by 1 | Viewed by 1134
Abstract
Facial hyperhidrosis is a debilitating condition that can severely impact the quality of life. This study aimed to assess the long-term utility of Botulinum toxin type A therapy (BTA) for facial hyperhidrosis and its impact on quality of life over a one-year period. [...] Read more.
Facial hyperhidrosis is a debilitating condition that can severely impact the quality of life. This study aimed to assess the long-term utility of Botulinum toxin type A therapy (BTA) for facial hyperhidrosis and its impact on quality of life over a one-year period. Conducted at the Pius Brinzeu Clinical Emergency Hospital in Timisoara, Romania, this longitudinal observational study involved 77 adult patients with primary facial hyperhidrosis. Participants received two sessions of Botulinum toxin injections (50 U IncoBTX-A each) and were evaluated at baseline, 6 months, and 12 months using the Hyperhidrosis Disease Severity Scale (HDSS), WHOQOL-BREF, Dermatology Life Quality Index (DLQI), and a bespoke survey. The study demonstrated significant reductions in HDSS scores from 3.6 ± 0.5 to 1.2 ± 0.8 post-treatment, sustained at 1.3 ± 0.6 at 12 months (p-value < 0.001). DLQI scores markedly decreased from 24.8 ± 4.2 to 6.2 ± 2.1 post-treatment, stabilizing at 6.5 ± 2.5 at 12 months (p-value < 0.001). Sweat production significantly dropped from 0.75 g ± 0.15 to 0.18 g ± 0.07 per 15 min (p-value < 0.001). WHOQOL-BREF scores improved notably in the mental domain from 66.7 ± 6.1 to 70.8 ± 5.2 at 12 months (p-value < 0.001), with physical and social domains also showing significant improvements. Correlation analysis revealed strong negative correlations between DLQI total score and HDSS (rho = −0.72, p-value < 0.001) and sweat production (rho = −0.68, p-value < 0.001). Regression analysis indicated significant predictors for DLQI total score, including HDSS (B Coefficient = −3.8, p-value < 0.001) and sweat production (B Coefficient = −2.2, p-value < 0.001). BTA therapy significantly improved the quality of life in facial hyperhidrosis patients, with lasting effects on symptom severity, sweat production, and quality of life domains. The correlation and regression analyses further substantiated the treatment’s impact on both physical and psychological aspects. These findings advocate Botulinum toxin as a viable long-term treatment for facial hyperhidrosis. Full article
(This article belongs to the Special Issue Uses of Botulinum Toxin Injection in Medicine)
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16 pages, 1740 KiB  
Article
Improvement in Quality-of-Life-Related Outcomes Following Treatment with IncobotulinumtoxinA in Adults with Limb Spasticity: A Pooled Analysis
by Franco Molteni, Jörg Wissel, Klemens Fheodoroff, Michael C. Munin, Atul T. Patel, Michael Althaus, Georg Comes, Andrzej Dekundy, Irena Pulte, Astrid Scheschonka, Matteo Vacchelli and Andrea Santamato
Toxins 2024, 16(1), 19; https://doi.org/10.3390/toxins16010019 - 29 Dec 2023
Viewed by 1285
Abstract
A strong correlation has been reported between patient-reported quality of life (QoL) and the investigator-rated Disability Assessment Scale (DAS) in patients with spasticity. The current analysis evaluates the effect of incobotulinumtoxinA on QoL-related outcomes (limb position abnormality, as well as dressing- and hygiene-related [...] Read more.
A strong correlation has been reported between patient-reported quality of life (QoL) and the investigator-rated Disability Assessment Scale (DAS) in patients with spasticity. The current analysis evaluates the effect of incobotulinumtoxinA on QoL-related outcomes (limb position abnormality, as well as dressing- and hygiene-related disability, measured with the DAS) in adults with upper limb spasticity, using pooled data from six studies. Separate analyses for each DAS domain were performed using data from patients with disabilities for that domain (DAS score ≥1). Results showed that a significantly greater proportion of incobotulinumtoxinA-treated compared with placebo-treated patients achieved a ≥1-point reduction from baseline in each of the DAS domains (improvement) 4 weeks after the first injection. The benefits of incobotulinumtoxinA were observed regardless of the baseline severity of DAS impairment and of the time elapsed since stroke. The effects of incobotulinumtoxinA 4 weeks after injection were maintained or enhanced over multiple injection cycles for all three DAS domains, supporting the use of repeated injection cycles to provide sustained QoL benefit. IncobotulinumtoxinA represents an important treatment option to achieve better QoL-related outcomes for patients with upper limb spasticity, irrespective of the duration of their condition. Full article
(This article belongs to the Special Issue Uses of Botulinum Toxin Injection in Medicine)
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24 pages, 2358 KiB  
Systematic Review
Botulinum Toxin Injections for Psychiatric Disorders: A Systematic Review of the Clinical Trial Landscape
by Ilya Demchenko, Alyssa Swiderski, Helen Liu, Hyejung Jung, Wendy Lou and Venkat Bhat
Toxins 2024, 16(4), 191; https://doi.org/10.3390/toxins16040191 - 15 Apr 2024
Viewed by 655
Abstract
Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders [...] Read more.
Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders to identify relevant trends in the field and discuss the refinement of therapeutic techniques. A comprehensive search for published clinical trials using BONT-A injections for psychiatric disorders was performed on 4 May 2023 through OVID databases (MEDLINE, Embase, APA PsycINFO). Unpublished clinical trials were searched through the ClinicalTrials.gov and International Clinical Trial Registry Platform public registries. The risk of bias was assessed using the JBI Critical Appraisal tools for use in systematic reviews. We identified 21 studies (17 published, 4 unpublished clinical trials) involving 471 patients. The studies focused on evaluating the efficacy of BONT-A for major depressive, borderline personality, social anxiety, and bipolar disorders. BONT-A was most commonly injected into the glabellar area, with an average dose ranging between 37.75 U and 44.5 U in published studies and between 32.7 U and 41.3 U in unpublished trials. The results indicated significant symptom reductions across all the studied psychiatric conditions, with mild adverse effects. Thus, BONT-A appears to be safe and well-tolerated for psychiatric disorders of negative affectivity. However, despite the clinical focus, there was a noted shortage of biomarker-related assessments. Future studies should focus on pursuing mechanistic explorations of BONT-A effects at the neurobiological level. Full article
(This article belongs to the Special Issue Uses of Botulinum Toxin Injection in Medicine)
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20 pages, 10428 KiB  
Systematic Review
Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials
by Lorenzo Lippi, Alessandro de Sire, Alessio Turco, Martina Ferrillo, Serdar Kesikburun, Alessio Baricich, Stefano Carda and Marco Invernizzi
Toxins 2024, 16(3), 153; https://doi.org/10.3390/toxins16030153 - 15 Mar 2024
Viewed by 1102
Abstract
Cancer pain is one of the most disabling symptoms complained by cancer patients, with a crucial impact on physical and psychological well-being. Botulinum neurotoxins (BoNTs) type A and B have emerged as potential interventions for chronic pain; however, their role in these patients [...] Read more.
Cancer pain is one of the most disabling symptoms complained by cancer patients, with a crucial impact on physical and psychological well-being. Botulinum neurotoxins (BoNTs) type A and B have emerged as potential interventions for chronic pain; however, their role in these patients is still debated. Thus, this systematic review of randomized controlled trials aimed at assessing the effects of BoNT treatment for cancer pain to guide physicians in an evidence-based approach integrating BoNT in cancer care. Out of 5824 records, 10 RCTs satisfied our eligibility criteria and were included in the present work for a total of 413 subjects with several cancer types (breast, head and neck, esophageal, and thoracic/gastric cancers). While some studies demonstrated significant pain reduction and improved quality of life post-BoNT-A injections, outcomes across different cancer types were inconclusive. Additionally, several effects were observed in functioning, dysphagia, salivary outcomes, esophageal strictures, gastric emptying, and expansions. This review emphasizes the need for further standardized research to conclusively establish the efficacy of BoNT in comprehensive cancer pain management. Full article
(This article belongs to the Special Issue Uses of Botulinum Toxin Injection in Medicine)
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