Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study

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 ef...
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Autor*in:	Claudia Ledda [verfasserIn] Elisa Panero [verfasserIn] Ugo Dimanico [verfasserIn] Mattia Parisi [verfasserIn] Marialuisa Gandolfi [verfasserIn] Michele Tinazzi [verfasserIn] Christian Geroin [verfasserIn] Francesco Marchet [verfasserIn] Giuseppe Massazza [verfasserIn] Leonardo Lopiano [verfasserIn] Carlo Alberto Artusi [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease

Übergeordnetes Werk:	In: Toxins - MDPI AG, 2010, 15(2023), 566, p 566
Übergeordnetes Werk:	volume:15 ; year:2023 ; number:566, p 566

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/toxins15090566

Katalog-ID:	DOAJ093257341

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520			\|a 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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.
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allfields	10.3390/toxins15090566 doi (DE-627)DOAJ093257341 (DE-599)DOAJa01be9d9e1a34e3c84f2c15a83f645b0 DE-627 ger DE-627 rakwb eng Claudia Ledda verfasserin aut Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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. botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R Elisa Panero verfasserin aut Ugo Dimanico verfasserin aut Mattia Parisi verfasserin aut Marialuisa Gandolfi verfasserin aut Michele Tinazzi verfasserin aut Christian Geroin verfasserin aut Francesco Marchet verfasserin aut Giuseppe Massazza verfasserin aut Leonardo Lopiano verfasserin aut Carlo Alberto Artusi verfasserin aut In Toxins MDPI AG, 2010 15(2023), 566, p 566 (DE-627)610604236 (DE-600)2518395-3 20726651 nnns volume:15 year:2023 number:566, p 566 https://doi.org/10.3390/toxins15090566 kostenfrei https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 kostenfrei https://www.mdpi.com/2072-6651/15/9/566 kostenfrei https://doaj.org/toc/2072-6651 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 566, p 566
spelling	10.3390/toxins15090566 doi (DE-627)DOAJ093257341 (DE-599)DOAJa01be9d9e1a34e3c84f2c15a83f645b0 DE-627 ger DE-627 rakwb eng Claudia Ledda verfasserin aut Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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. botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R Elisa Panero verfasserin aut Ugo Dimanico verfasserin aut Mattia Parisi verfasserin aut Marialuisa Gandolfi verfasserin aut Michele Tinazzi verfasserin aut Christian Geroin verfasserin aut Francesco Marchet verfasserin aut Giuseppe Massazza verfasserin aut Leonardo Lopiano verfasserin aut Carlo Alberto Artusi verfasserin aut In Toxins MDPI AG, 2010 15(2023), 566, p 566 (DE-627)610604236 (DE-600)2518395-3 20726651 nnns volume:15 year:2023 number:566, p 566 https://doi.org/10.3390/toxins15090566 kostenfrei https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 kostenfrei https://www.mdpi.com/2072-6651/15/9/566 kostenfrei https://doaj.org/toc/2072-6651 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 566, p 566
allfields_unstemmed	10.3390/toxins15090566 doi (DE-627)DOAJ093257341 (DE-599)DOAJa01be9d9e1a34e3c84f2c15a83f645b0 DE-627 ger DE-627 rakwb eng Claudia Ledda verfasserin aut Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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. botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R Elisa Panero verfasserin aut Ugo Dimanico verfasserin aut Mattia Parisi verfasserin aut Marialuisa Gandolfi verfasserin aut Michele Tinazzi verfasserin aut Christian Geroin verfasserin aut Francesco Marchet verfasserin aut Giuseppe Massazza verfasserin aut Leonardo Lopiano verfasserin aut Carlo Alberto Artusi verfasserin aut In Toxins MDPI AG, 2010 15(2023), 566, p 566 (DE-627)610604236 (DE-600)2518395-3 20726651 nnns volume:15 year:2023 number:566, p 566 https://doi.org/10.3390/toxins15090566 kostenfrei https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 kostenfrei https://www.mdpi.com/2072-6651/15/9/566 kostenfrei https://doaj.org/toc/2072-6651 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 566, p 566
allfieldsGer	10.3390/toxins15090566 doi (DE-627)DOAJ093257341 (DE-599)DOAJa01be9d9e1a34e3c84f2c15a83f645b0 DE-627 ger DE-627 rakwb eng Claudia Ledda verfasserin aut Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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. botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R Elisa Panero verfasserin aut Ugo Dimanico verfasserin aut Mattia Parisi verfasserin aut Marialuisa Gandolfi verfasserin aut Michele Tinazzi verfasserin aut Christian Geroin verfasserin aut Francesco Marchet verfasserin aut Giuseppe Massazza verfasserin aut Leonardo Lopiano verfasserin aut Carlo Alberto Artusi verfasserin aut In Toxins MDPI AG, 2010 15(2023), 566, p 566 (DE-627)610604236 (DE-600)2518395-3 20726651 nnns volume:15 year:2023 number:566, p 566 https://doi.org/10.3390/toxins15090566 kostenfrei https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 kostenfrei https://www.mdpi.com/2072-6651/15/9/566 kostenfrei https://doaj.org/toc/2072-6651 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 566, p 566
allfieldsSound	10.3390/toxins15090566 doi (DE-627)DOAJ093257341 (DE-599)DOAJa01be9d9e1a34e3c84f2c15a83f645b0 DE-627 ger DE-627 rakwb eng Claudia Ledda verfasserin aut Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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. botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R Elisa Panero verfasserin aut Ugo Dimanico verfasserin aut Mattia Parisi verfasserin aut Marialuisa Gandolfi verfasserin aut Michele Tinazzi verfasserin aut Christian Geroin verfasserin aut Francesco Marchet verfasserin aut Giuseppe Massazza verfasserin aut Leonardo Lopiano verfasserin aut Carlo Alberto Artusi verfasserin aut In Toxins MDPI AG, 2010 15(2023), 566, p 566 (DE-627)610604236 (DE-600)2518395-3 20726651 nnns volume:15 year:2023 number:566, p 566 https://doi.org/10.3390/toxins15090566 kostenfrei https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 kostenfrei https://www.mdpi.com/2072-6651/15/9/566 kostenfrei https://doaj.org/toc/2072-6651 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 566, p 566
language	English
source	In Toxins 15(2023), 566, p 566 volume:15 year:2023 number:566, p 566
sourceStr	In Toxins 15(2023), 566, p 566 volume:15 year:2023 number:566, p 566
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease Medicine R
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container_title	Toxins
authorswithroles_txt_mv	Claudia Ledda @@aut@@ Elisa Panero @@aut@@ Ugo Dimanico @@aut@@ Mattia Parisi @@aut@@ Marialuisa Gandolfi @@aut@@ Michele Tinazzi @@aut@@ Christian Geroin @@aut@@ Francesco Marchet @@aut@@ Giuseppe Massazza @@aut@@ Leonardo Lopiano @@aut@@ Carlo Alberto Artusi @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
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spellingShingle	Claudia Ledda misc botulinum toxin misc lateral trunk flexion misc Pisa syndrome misc Parkinson’s disease misc Medicine misc R Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
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topic_title	Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study botulinum toxin lateral trunk flexion Pisa syndrome Parkinson’s disease
topic	misc botulinum toxin misc lateral trunk flexion misc Pisa syndrome misc Parkinson’s disease misc Medicine misc R
topic_unstemmed	misc botulinum toxin misc lateral trunk flexion misc Pisa syndrome misc Parkinson’s disease misc Medicine misc R
topic_browse	misc botulinum toxin misc lateral trunk flexion misc Pisa syndrome misc Parkinson’s disease misc Medicine misc R
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title	Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
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title_full	Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
author_sort	Claudia Ledda
journal	Toxins
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author_browse	Claudia Ledda Elisa Panero Ugo Dimanico Mattia Parisi Marialuisa Gandolfi Michele Tinazzi Christian Geroin Francesco Marchet Giuseppe Massazza Leonardo Lopiano Carlo Alberto Artusi
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title_sort	longitudinal assessment of botulinum toxin treatment for lateral trunk flexion and pisa syndrome in parkinson’s disease: real-life, long-term study
title_auth	Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
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 (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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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.
abstractGer	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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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.
abstract_unstemmed	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% (<i<p</i< = 0.237). In comparison, the seven untreated PD patients suffered a deterioration in LTF over 12 months by 36 ± 45% (<i<p</i< = 0.116), showing a significantly different trajectory of posture change (<i<p</i< = 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.
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title_short	Longitudinal Assessment of Botulinum Toxin Treatment for Lateral Trunk Flexion and Pisa Syndrome in Parkinson’s Disease: Real-life, Long-Term Study
url	https://doi.org/10.3390/toxins15090566 https://doaj.org/article/a01be9d9e1a34e3c84f2c15a83f645b0 https://www.mdpi.com/2072-6651/15/9/566 https://doaj.org/toc/2072-6651
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author2	Elisa Panero Ugo Dimanico Mattia Parisi Marialuisa Gandolfi Michele Tinazzi Christian Geroin Francesco Marchet Giuseppe Massazza Leonardo Lopiano Carlo Alberto Artusi
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up_date	2024-07-03T16:13:23.052Z
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