Shivam Om Mittal1, Duarte Machado2, Diana Richardson3, Divyanshu Dubey4, Bahman Jabbari3. 1. Department of Neurology, Yale University School of Medicine, New Haven, CT, USA; Department of Neurology, Columbia Asia Hospitals, Sarjapur Road, Bangalore, India; Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: neurology.mittal@gmail.com. 2. Department of Neurology, Yale University School of Medicine, New Haven, CT, USA; Department of Neurology, Hartford Healthcare Ayer Neuroscience Institute, Hartford, CT, USA. 3. Department of Neurology, Yale University School of Medicine, New Haven, CT, USA. 4. Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, MA, USA.
Abstract
INTRODUCTION: To evaluate the safety and efficacy of incobotulinumtoxinA (IncoA) injection for treatment of essential hand tremor. In essential tremor and Parkinson's disease tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor but a high percentage of patients (30-70%) develop moderate to severe hand weakness which has limited its use in clinical practice. METHODS: This study was performed from July 2013 to July 2016 on 33 subjects. This is a double-blind, placebo-controlled, crossover trial injecting 80-120 units of IncoA into 8-14 hand and forearm muscles using a customized approach. The subjects were followed for 28 weeks. The treatment efficacy was evaluated by the Fahn Tolosa Marin tremor rating score and NIH genetic criteria for tremor severity at 4 and 8 weeks after each of the two sets of treatments. Hand strength was assessed by an ergometer. RESULTS: There was statistically significant improvement in clinical rating score of tremor at 4 and 8 weeks following the IncoA injection. CONCLUSION: In this study, injection of IncoA treatment via a customized approach improved essential tremor on the clinical scales and patient's perception with a low occurrence of significant hand weakness.
RCT Entities:
INTRODUCTION: To evaluate the safety and efficacy of incobotulinumtoxinA (IncoA) injection for treatment of essential hand tremor. In essential tremor and Parkinson's disease tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor but a high percentage of patients (30-70%) develop moderate to severe hand weakness which has limited its use in clinical practice. METHODS: This study was performed from July 2013 to July 2016 on 33 subjects. This is a double-blind, placebo-controlled, crossover trial injecting 80-120 units of IncoA into 8-14 hand and forearm muscles using a customized approach. The subjects were followed for 28 weeks. The treatment efficacy was evaluated by the Fahn Tolosa Marin tremor rating score and NIH genetic criteria for tremor severity at 4 and 8 weeks after each of the two sets of treatments. Hand strength was assessed by an ergometer. RESULTS: There was statistically significant improvement in clinical rating score of tremor at 4 and 8 weeks following the IncoA injection. CONCLUSION: In this study, injection of IncoA treatment via a customized approach improved essential tremor on the clinical scales and patient's perception with a low occurrence of significant hand weakness.
Authors: Mandar Jog; Jack Lee; Astrid Scheschonka; Robert Chen; Farooq Ismail; Chris Boulias; Douglas Hobson; David King; Michael Althaus; Olivier Simon; Hanna Dersch; Steven Frucht; David M Simpson Journal: Toxins (Basel) Date: 2020-12-20 Impact factor: 4.546
Authors: Hortensia Alonso-Navarro; Elena García-Martín; José A G Agúndez; Félix J Jiménez-Jiménez Journal: Curr Neuropharmacol Date: 2020 Impact factor: 7.363