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Toxins
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Botulinum Neurotoxin as a Novel Therapy for Parkinson’s Disease
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Botulinum Neurotoxin as a Novel Therapy for Parkinson’s Disease

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

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 3053

Special Issue Editor

Dr. Matteo Costanzo

E-Mail Website
Guest Editor
Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy
Interests: neurodegenerative diseases; movement disorders

Special Issue Information

Dear Colleagues,

Parkinson’s disease is a multisystem disorder with a number of motor and non-motor symptoms. Dopaminergic treatment is effective in managing motor symptoms but can be limited by side effects. At the same time, non-motor symptoms, now considered a relevant source of disability in Parkinson’s disease, respond poorly to dopaminergic therapy. Over the preceding decades, Botulinum toxin (BoNT) has gained widespread use in several neurological disorders. Amongst the investigated fields of application of BoNT is the management of a variety of symptoms associated with parkinsonism, mainly including motor disorders, autonomic symptoms and pain. Indeed, the main feature that could make BoNT suitable for use in the therapy of Parkinson’s disease is its safety, due to the fact that it has mostly local side effects, avoiding interference with dopaminergic and non-dopaminergic therapies commonly prescribed for parkinsonian patients. With a great number of studies being published, it is crucial to collate up-to-date scientific advances in the emerging application of BoNT as a promising therapy of Parkinson’s disease. To this aim, we have inaugurated this Special Issue of Toxin, entitled “Botulinum Neurotoxin as a novel therapy of Parkinson’s disease”, has been compiled to provide scientific evidence on various clinical indications of BoNT in the management of motor and non-motor symptoms associated with Parkinson’s disease. We welcome expert reviews, as well as research papers, on the following sub-topics:

  • Botulinum Toxin treatment of motor disorders in Parkinson’s disease, including tremor, dystonia, rigidity and camptocormia
  • Botulinum Toxin treatment of autonomic disorders in Parkinson’s disease, including sialorrhea, urinary disfunction, dysphagia, gastroparesis, constipation and sweating dysfunction.
  • Botulinum Toxin treatment of pain in Parkinson’s disease.
  • Botulinum Toxin treatment of motor and non-motor symptoms in atypical parkinsonisms.

Dr. Matteo Costanzo
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

  • Parkinson’s disease
  • botulinum toxin
  • non-motor symptoms
  • motor symptoms
  • therapy

Published Papers (2 papers)

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12 pages, 2143 KiB  
Article
Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
by Claudia Ledda, Elisa Panero, Ugo Dimanico, Mattia Parisi, Marialuisa Gandolfi, Michele Tinazzi, Christian Geroin, Francesco Marchet, Giuseppe Massazza, Leonardo Lopiano and Carlo Alberto Artusi
Toxins 2023, 15(9), 566; https://doi.org/10.3390/toxins15090566 - 11 Sep 2023
Cited by 2 | Viewed by 1265
Abstract
Lateral trunk flexion (LTF) and its severe form, called Pisa syndrome (PS), are highly invalidating axial postural abnormalities associated with Parkinson’s disease (PD). Management strategies for LTF lack strong scientific evidence. We present a real-life, longitudinal study evaluating long-term efficacy of botulinum toxin [...] Read more.
Lateral trunk flexion (LTF) and its severe form, called Pisa syndrome (PS), are highly invalidating axial postural abnormalities associated with Parkinson’s disease (PD). Management strategies for LTF lack strong scientific evidence. We present a real-life, longitudinal study evaluating long-term efficacy of botulinum toxin (BoNT) injections in axial muscles to reduce LTF and PS in PD. A total of 13 PD patients with LTF > 5° received ultrasound- and electromyography-guided BoNT injections every 4 months. Seven untreated matched PD patients with LTF served as controls and their changes in posture after 18 months were compared with those of seven patients continuing BoNT over 12 months. 53.8% of patients continued the BoNT injections for at least 12 months. Various individual LTF responses were observed. Overall, BoNT-treated patients obtained a not statistically significant improvement of LTF of 17 ± 41% (p = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (p = 0.116), showing a significantly different trajectory of posture change (p = 0.026). In conclusion, repeated BoNT injections in axial muscles showed varying effects in managing PD-associated LTF, suggesting that: (a) a relevant number of patients with LTF can benefit from BoNT; (b) long-term treatment could prevent LTF worsening; (c) an instrumented, personalized approach is important; and (d) there is a need for prospective, long-term studies. Full article
(This article belongs to the Special Issue Botulinum Neurotoxin as a Novel Therapy for Parkinson’s Disease)
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22 pages, 724 KiB  
Systematic Review
Exploring the Central Mechanisms of Botulinum Toxin in Parkinson’s Disease: A Systematic Review from Animal Models to Human Evidence
by Carolina Cutrona, Francesco Marchet, Matteo Costanzo, Maria Ilenia De Bartolo, Giorgio Leodori, Gina Ferrazzano, Antonella Conte, Giovanni Fabbrini, Alfredo Berardelli and Daniele Belvisi
Toxins 2024, 16(1), 9; https://doi.org/10.3390/toxins16010009 - 23 Dec 2023
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Abstract
Botulinum toxin (BoNT) is an effective and safe therapy for the symptomatic treatment of several neurological disturbances. An important line of research has provided numerous pieces of evidence about the mechanisms of action of BoNT in the central nervous system, especially in the [...] Read more.
Botulinum toxin (BoNT) is an effective and safe therapy for the symptomatic treatment of several neurological disturbances. An important line of research has provided numerous pieces of evidence about the mechanisms of action of BoNT in the central nervous system, especially in the context of dystonia and spasticity. However, only a few studies focused on the possible central effects of BoNT in Parkinson’s disease (PD). We performed a systematic review to describe and discuss the evidence from studies focused on possible central effects of BoNT in PD animal models and PD patients. To this aim, a literature search in PubMed and SCOPUS was performed in May 2023. The records were screened according to title and abstract by two independent reviewers and relevant articles were selected for full-text review. Most of the papers highlighted by our review report that the intrastriatal administration of BoNT, through local anticholinergic action and the remodulation of striatal compensatory mechanisms secondary to dopaminergic denervation, induces an improvement in motor and non-motor symptoms in the absence of neuronal loss in animal models of PD. In human subjects, the data are scarce: a single neurophysiological study in tremulous PD patients found that the change in tremor severity after peripheral BoNT administration was associated with improved sensory–motor integration and intracortical inhibition measures. Further clinical, neurophysiological, and neuroimaging studies are necessary to clarify the possible central effects of BoNT in PD. Full article
(This article belongs to the Special Issue Botulinum Neurotoxin as a Novel Therapy for Parkinson’s Disease)
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