Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials
Abstract
:1. Introduction
2. Results
2.1. Effects in Essential Tremor
2.2. Effects in Hands Tremor
2.3. Muscle Weakness
3. Discussion
4. Conclusions
5. Materials and Methods
5.1. Inclusion Criteria
5.2. Search Strategy and Study Selection
5.3. Data Extraction
5.4. Appraisal of Methodological Quality
5.5. Outcomes
5.6. Statistical Analysis
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author (Year) | Inclusion Criteria | No. of Patients (Male, %) | Age, Mean ± SD (y) | Treatment Target | Intervention | Outcome Measurement | Side Effect |
---|---|---|---|---|---|---|---|
Boonstra et al. (2020) [23] | RRMS, SPMS, or PPMS with unilateral hand tremor | 43 (11, 25.6%) | E 45.9 ± 13.5 C 47.0 ± 7.55 | Upper limbs | BT 100 U | Bain composite tremor score (0–10) at 6 and 12 weeks | Significant decrease in muscle strength |
Brin et al. (2001) [24] | ET with bilateral postural hand tremor | 133 (90, 68%) | 68.5 ± 11.2 | Upper limbs | Low dose: BT 50 U; high dose: BT 100 U | Subjective assessment by investigator compared with baseline (−4 to 4) at 6 and 12 weeks | Weakness, pain in injection site, stiffness, cramping, hematoma, and paresthesia |
Jankovic et al. (1996) [25] | ET with moderate to severe tremor | 25 (16, 64%) | E 56.2 ± 13.0 C 67.4 ± 12.4 | Upper limbs | BT 50 U | Functional severity of tremor (0–4) | Mild and moderate finger weakness |
Jog et al. (2020) [26] | ET with moderate to severe tremor | 30 (15, 50.0%) | E 68.1 ± 10.6 C 68.2 ± 10.2 | Upper limbs | Mean dose: BT 116.3 U | Fahn–Tolosa–Marin Part B motor performance score | Localized muscular weakness, dry mouth, and dysphonia |
Mittal et al. (2017) [27] | PD with moderate to severe tremor | 30 (23, 77%) | E 68.50 (range: 57–87) C 62 (range: 51–81) | Upper limbs | BT 85–110 U with follow-ups at 4 and 8 weeks | UPDRS Section 16 at 4 and 8 weeks | Weakness in some patients |
Mittal et al. (2018) [28] | ET with moderate to severe tremor | 28 (13, 46.2%) | E 70 (range: 43–81) C 62.5 (range: 25–82) | Upper limbs | BT 80–120 U | NIHCGC (0–4) at 4 and 8 weeks | Mild hand weakness (from a few days to 4 weeks) |
Pahwa et al. (1996) [29] | ET with horizontal head tremor | 10 (1, 10%) | 65.9 (range: 50–82) | Head | BT 100 U | Subjective assessment involving baseline comparison (−3 to 3) at 4 and 8 weeks | Neck weakness, swallowing difficulty, headache, and dizziness |
Van Der Walt et al. (2012) [30] | RRMS or SPMS with disabling hand tremor | 23 (6, 26%) | 49.6 ± 11.0 | Upper limbs | BT 35–100 U | Bain composite tremor score (0–10) at 6 and 12 weeks | Weakness (resolved in 2 weeks) |
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Liao, Y.-H.; Hong, C.-T.; Huang, T.-W. Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials. Toxins 2022, 14, 203. https://doi.org/10.3390/toxins14030203
Liao Y-H, Hong C-T, Huang T-W. Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials. Toxins. 2022; 14(3):203. https://doi.org/10.3390/toxins14030203
Chicago/Turabian StyleLiao, Yen-Hui, Chien-Tai Hong, and Tsai-Wei Huang. 2022. "Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials" Toxins 14, no. 3: 203. https://doi.org/10.3390/toxins14030203