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Toxins
Special Issues
Clinical Application of Botulinum Toxin 2.0
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Clinical Application of Botulinum Toxin 2.0

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

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10562

Special Issue Editor

Prof. Dr. Markus K. Naumann

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Guest Editor
Department of Neurology and Clinical Neurophysiology, University of Augsburg, 86159 Augsburg, Germany
Interests: movement disorders; botulinum toxin; autonomic disorders; neurophysiology; neuroimaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This is a second adaptation of the previous Special Issue, which attracted several papers on the clinical use of botulinum toxin. This Special Issue also intends to unite papers on such a topic. Botulinum toxin, the most potent biological toxin, has become a powerful therapeutic tool for a growing number of clinical applications. It has been approved for many disorders (including movement disorders and autonomic disorders (i.e., secretory and bladder)), pain, and ophthalmologic uses. Among movement disorders, it has revolutionized the treatment of focal spasticity of upper and lower limbs, focal dystonias, and some other rare conditions. In spasticity and dystonia, the mode of action of botulinum toxin is complex and is not only based on a blockage of acetylcholine release at the neuromuscular junction, leading to muscle weakness. Due to its effect on muscle spindles, it exerts an additional effect on different pathways to the central nervous system, thereby markedly contributing to beneficial clinical effects. There is increasing evidence that treatment outcomes can be optimized using guided injection techniques.

This Special Issue of Toxins explores the botulinum toxin treatment of movement disorders, in all its aspects, including treatment outcomes in focal spasticity, dystonias, tremors, and other movement disorders; the effects of different serotypes; dosing and side effects; antigenicity; evidence-based medicine; guided injection techniques (ultrasound, EMG, stimulation, and imaging); sensorimotor aspects of mode of action; and others.

Prof. Dr. Markus K. Naumann
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
  • spasticity
  • dystonia
  • mode of action
  • guidance
  • outcome
  • clinic therapy

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Published Papers (2 papers)

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Research

14 pages, 2470 KiB  
Article
Optimizing Botulinum Toxin A Administration for Forehead Wrinkles: Introducing the Lines and Dots (LADs) Technique and a Predictive Dosage Model
by Kamal Alhallak
Toxins 2024, 16(2), 109; https://doi.org/10.3390/toxins16020109 - 17 Feb 2024
Viewed by 5593
Abstract
This study introduces the Lines and Dots (LADs) technique, a new approach for administering botulinum toxin type A (BoNT-A) in treating forehead wrinkles. (1) Background: BoNT-A application patterns in the forehead often rely solely on the anatomy of the frontalis muscle. The LADs [...] Read more.
This study introduces the Lines and Dots (LADs) technique, a new approach for administering botulinum toxin type A (BoNT-A) in treating forehead wrinkles. (1) Background: BoNT-A application patterns in the forehead often rely solely on the anatomy of the frontalis muscle. The LADs technique proposes a combination of anatomical features with nerve pathways. (2) Methods: The technique employed a grid system aligned with the supraorbital and supratrochlear nerve pathways and used an electronic acupuncture pen for validation. This study analyzed treatment outcomes for efficacy and safety and proposed a predictive model for BoNT-A dosage. (3) Results: LADs was associated with a high satisfaction rate and low side effect incidence. The predictive model followed BoNT-A Units=0.322×Muscle Pattern Code+1.282×Line Type Code+2.905×Severity Pre-Treatment+3.947. (4) Conclusions: The LADs technique offers an alternative approach to treating forehead wrinkles, optimizing efficacy while minimizing the BoNT-A dose required. Full article
(This article belongs to the Special Issue Clinical Application of Botulinum Toxin 2.0)
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9 pages, 1215 KiB  
Communication
Safety and Effectiveness of Repeated Botulinum Toxin A Intracavernosal Injections in Men with Erectile Dysfunction Unresponsive to Approved Pharmacological Treatments: Real-World Observational Data
by François Giuliano, Pierre Denys and Charles Joussain
Toxins 2023, 15(6), 382; https://doi.org/10.3390/toxins15060382 - 5 Jun 2023
Cited by 3 | Viewed by 4361
Abstract
Intracavernosal injections of botulinum toxin A (BTX/A ic) may be effective for difficult-to-treat erectile dysfunction (ED). This is a retrospective case series study of the effectiveness of repeated off-label BTX/A ic (onabotulinumtoxinA 100U, incobotulinumtoxinA 100U or abobotulinumtoxinA 500U) in men with ED [...] Read more.
Intracavernosal injections of botulinum toxin A (BTX/A ic) may be effective for difficult-to-treat erectile dysfunction (ED). This is a retrospective case series study of the effectiveness of repeated off-label BTX/A ic (onabotulinumtoxinA 100U, incobotulinumtoxinA 100U or abobotulinumtoxinA 500U) in men with ED and insufficient response to phosphodiesterase type 5 inhibitors (PDE5-Is) or prostaglandinE1 intracavernosal injections (PGE1 ICIs), defined as an International Index of Erectile Function-Erectile Function domain score (IIEF-EF) < 26 on treatment. Further injections were performed on patients’ requests, and the files of men who underwent at least two injections were reviewed. The response to BTX/A ic was defined as the achievement of the minimally clinically important difference in IIEF-EF adjusted to the severity of ED on treatment at baseline. Out of 216 men treated with BTX/A ic and PDE5-Is or PGE1-ICIs, 92 (42.6%) requested at least a second injection. The median time since the preceding injection was 8.7 months. In total, 85, 44 and 23 men received, respectively, two, three and four BTX/A ic. The overall response rate was 77.5%: 85.7% in men with mild ED, 79% for moderate ED and 64.3% for severe ED on treatment. The response increased with repeated injections: 67.5%, 87.5% and 94.7%, respectively, after the second, third and fourth injections. Post-injection changes in IIEF-EF were similar across injections. The time from injection to request for a further injection varied little. Four men reported penile pain at the time of injection (1.5% of all injections), and one experienced a burn at the penile crus. Repeated BTX/A injections combined with PDE5-Is or PGE1-ICIs produced an effective and durable response, with acceptable safety. Full article
(This article belongs to the Special Issue Clinical Application of Botulinum Toxin 2.0)
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