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Intramuscular distribution of botulinum toxin—Visualized by MRI
Abstract Objective A precise knowledge of the spread of botulinum toxin (BoNT) in muscle tissue is required to efficiently access endplate zones and increase BoNT's therapeutic efficacy. Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its mod...
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Published in: | Journal of the neurological sciences 2014-09, Vol.344 (1), p.76-79 |
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description | Abstract Objective A precise knowledge of the spread of botulinum toxin (BoNT) in muscle tissue is required to efficiently access endplate zones and increase BoNT's therapeutic efficacy. Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its modulating factors, such as injected volume and exercise after injection. Methods To visualize distribution in muscle tissue, sagittal, dynamic, balanced fast field echo (BFFE) MRI imaging was performed during injection of 1 ml BoNT/NaCl bolus in spastic biceps brachii muscles (SBB, n = 4), and 1 ml NaCl in the right and 2 ml NaCl in the left healthy biceps brachii (HBB, n = 6), with or without successive muscle exercise. The pattern of extracellular fluid distribution was evaluated by T2-weighted and diffusion tensor imaging (DTI) sequences. Results BFFE indicated an immediate increase in hyperintensity, parallel to the muscle fibers, in the shape of a long (5.3 ± 1.7 cm) and thin (0.52 ± 1.3 cm) layer in HBB. The layer in SBB was shorter (3.25 ± 0.6 cm, p = 0.01) and tended to be thicker (0.74 ± 2.9 cm, p = 0.27). In HBB, an increase in volume (2 ml) resulted in an increase in thickness (0.95 ± 0.2 cm, p = 0.015), but a consistent length (5.67 ± 1.3 cm, p = 0.54). DTI visualized a change of diffusion, which exceeded the bolus region by approximately 0.5 cm. Redistribution occurred 10 min after injection and was more prominent in HBB, compared to SBB. Additional muscle activity did not alter the diffusion pattern or bolus distribution. Conclusion Injecting BoNT at different depths perpendicular to the direction of the muscle fiber might optimize the efficacy of BoNT treatment. Additional sites along muscle fibers should be considered in SBB. |
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Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its modulating factors, such as injected volume and exercise after injection. Methods To visualize distribution in muscle tissue, sagittal, dynamic, balanced fast field echo (BFFE) MRI imaging was performed during injection of 1 ml BoNT/NaCl bolus in spastic biceps brachii muscles (SBB, n = 4), and 1 ml NaCl in the right and 2 ml NaCl in the left healthy biceps brachii (HBB, n = 6), with or without successive muscle exercise. The pattern of extracellular fluid distribution was evaluated by T2-weighted and diffusion tensor imaging (DTI) sequences. Results BFFE indicated an immediate increase in hyperintensity, parallel to the muscle fibers, in the shape of a long (5.3 ± 1.7 cm) and thin (0.52 ± 1.3 cm) layer in HBB. The layer in SBB was shorter (3.25 ± 0.6 cm, p = 0.01) and tended to be thicker (0.74 ± 2.9 cm, p = 0.27). In HBB, an increase in volume (2 ml) resulted in an increase in thickness (0.95 ± 0.2 cm, p = 0.015), but a consistent length (5.67 ± 1.3 cm, p = 0.54). DTI visualized a change of diffusion, which exceeded the bolus region by approximately 0.5 cm. Redistribution occurred 10 min after injection and was more prominent in HBB, compared to SBB. Additional muscle activity did not alter the diffusion pattern or bolus distribution. Conclusion Injecting BoNT at different depths perpendicular to the direction of the muscle fiber might optimize the efficacy of BoNT treatment. Additional sites along muscle fibers should be considered in SBB.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2014.06.028</identifier><identifier>PMID: 25023196</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Aged ; Botulinum toxin ; Botulinum Toxins - metabolism ; Botulinum Toxins - therapeutic use ; Diffusion Tensor Imaging ; Distribution ; Female ; Humans ; Injections, Intramuscular ; Magnetic Resonance Imaging ; Male ; Middle Aged ; MRI ; Muscle, Skeletal - drug effects ; Muscle, Skeletal - metabolism ; Neurology ; Neurotoxins - metabolism ; Neurotoxins - therapeutic use ; Spasm - drug therapy ; Spasm - pathology ; Spasticity ; Young Adult</subject><ispartof>Journal of the neurological sciences, 2014-09, Vol.344 (1), p.76-79</ispartof><rights>Elsevier B.V.</rights><rights>2014 Elsevier B.V.</rights><rights>Copyright © 2014 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-de81abfa65abd31dd5465cba2d42e5da537a764352785718876227fa019f918a3</citedby><cites>FETCH-LOGICAL-c441t-de81abfa65abd31dd5465cba2d42e5da537a764352785718876227fa019f918a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25023196$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elwischger, K</creatorcontrib><creatorcontrib>Kasprian, G</creatorcontrib><creatorcontrib>Weber, M</creatorcontrib><creatorcontrib>Meyerspeer, M</creatorcontrib><creatorcontrib>Linder, C</creatorcontrib><creatorcontrib>Auff, E</creatorcontrib><creatorcontrib>Prayer, D</creatorcontrib><creatorcontrib>Sycha, T</creatorcontrib><creatorcontrib>Kranz, G</creatorcontrib><title>Intramuscular distribution of botulinum toxin—Visualized by MRI</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Abstract Objective A precise knowledge of the spread of botulinum toxin (BoNT) in muscle tissue is required to efficiently access endplate zones and increase BoNT's therapeutic efficacy. Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its modulating factors, such as injected volume and exercise after injection. Methods To visualize distribution in muscle tissue, sagittal, dynamic, balanced fast field echo (BFFE) MRI imaging was performed during injection of 1 ml BoNT/NaCl bolus in spastic biceps brachii muscles (SBB, n = 4), and 1 ml NaCl in the right and 2 ml NaCl in the left healthy biceps brachii (HBB, n = 6), with or without successive muscle exercise. The pattern of extracellular fluid distribution was evaluated by T2-weighted and diffusion tensor imaging (DTI) sequences. Results BFFE indicated an immediate increase in hyperintensity, parallel to the muscle fibers, in the shape of a long (5.3 ± 1.7 cm) and thin (0.52 ± 1.3 cm) layer in HBB. The layer in SBB was shorter (3.25 ± 0.6 cm, p = 0.01) and tended to be thicker (0.74 ± 2.9 cm, p = 0.27). In HBB, an increase in volume (2 ml) resulted in an increase in thickness (0.95 ± 0.2 cm, p = 0.015), but a consistent length (5.67 ± 1.3 cm, p = 0.54). DTI visualized a change of diffusion, which exceeded the bolus region by approximately 0.5 cm. Redistribution occurred 10 min after injection and was more prominent in HBB, compared to SBB. Additional muscle activity did not alter the diffusion pattern or bolus distribution. Conclusion Injecting BoNT at different depths perpendicular to the direction of the muscle fiber might optimize the efficacy of BoNT treatment. Additional sites along muscle fibers should be considered in SBB.</description><subject>Adult</subject><subject>Aged</subject><subject>Botulinum toxin</subject><subject>Botulinum Toxins - metabolism</subject><subject>Botulinum Toxins - therapeutic use</subject><subject>Diffusion Tensor Imaging</subject><subject>Distribution</subject><subject>Female</subject><subject>Humans</subject><subject>Injections, Intramuscular</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>MRI</subject><subject>Muscle, Skeletal - drug effects</subject><subject>Muscle, Skeletal - metabolism</subject><subject>Neurology</subject><subject>Neurotoxins - metabolism</subject><subject>Neurotoxins - therapeutic use</subject><subject>Spasm - drug therapy</subject><subject>Spasm - pathology</subject><subject>Spasticity</subject><subject>Young Adult</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu1DAURS1ERYfCB7BBWbJJeM-OHUdISFVF6UhFSEArdpZjO5JDEhc7RkxX_Qi-kC9pRlNYsGD1Nude6Z1LyAuECgHF66Ea5lRRwLoCUQGVj8gGZSNLLiV7TDYAlJYc4esxeZrSAABCyvYJOaYcKMNWbMjpdl6innIyedSxsD4t0Xd58WEuQl90Ycmjn_NULOGnn3_f_br2KevR3zpbdLviw6ftM3LU6zG55w_3hFydv_tydlFefny_PTu9LE1d41JaJ1F3vRZcd5ahtbwW3HSa2po6bjVnjW5EzThtJG9QykZQ2vQasO1blJqdkFeH3psYvmeXFjX5ZNw46tmFnBRyzgVtWtauKB5QE0NK0fXqJvpJx51CUHtzalCrObU3p0Co1dyaeflQn7vJ2b-JP6pW4M0BcOuTP7yLKhnvZuOsj84sygb_3_q3_6TN6tUbPX5zO5eGkOO82lOoElWgPu-n2y-HNQBrJbB7f-GUVA</recordid><startdate>20140915</startdate><enddate>20140915</enddate><creator>Elwischger, K</creator><creator>Kasprian, G</creator><creator>Weber, M</creator><creator>Meyerspeer, M</creator><creator>Linder, C</creator><creator>Auff, E</creator><creator>Prayer, D</creator><creator>Sycha, T</creator><creator>Kranz, G</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140915</creationdate><title>Intramuscular distribution of botulinum toxin—Visualized by MRI</title><author>Elwischger, K ; Kasprian, G ; Weber, M ; Meyerspeer, M ; Linder, C ; Auff, E ; Prayer, D ; Sycha, T ; Kranz, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-de81abfa65abd31dd5465cba2d42e5da537a764352785718876227fa019f918a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Botulinum toxin</topic><topic>Botulinum Toxins - metabolism</topic><topic>Botulinum Toxins - therapeutic use</topic><topic>Diffusion Tensor Imaging</topic><topic>Distribution</topic><topic>Female</topic><topic>Humans</topic><topic>Injections, Intramuscular</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>MRI</topic><topic>Muscle, Skeletal - drug effects</topic><topic>Muscle, Skeletal - metabolism</topic><topic>Neurology</topic><topic>Neurotoxins - metabolism</topic><topic>Neurotoxins - therapeutic use</topic><topic>Spasm - drug therapy</topic><topic>Spasm - pathology</topic><topic>Spasticity</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elwischger, K</creatorcontrib><creatorcontrib>Kasprian, G</creatorcontrib><creatorcontrib>Weber, M</creatorcontrib><creatorcontrib>Meyerspeer, M</creatorcontrib><creatorcontrib>Linder, C</creatorcontrib><creatorcontrib>Auff, E</creatorcontrib><creatorcontrib>Prayer, D</creatorcontrib><creatorcontrib>Sycha, T</creatorcontrib><creatorcontrib>Kranz, G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elwischger, K</au><au>Kasprian, G</au><au>Weber, M</au><au>Meyerspeer, M</au><au>Linder, C</au><au>Auff, E</au><au>Prayer, D</au><au>Sycha, T</au><au>Kranz, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intramuscular distribution of botulinum toxin—Visualized by MRI</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2014-09-15</date><risdate>2014</risdate><volume>344</volume><issue>1</issue><spage>76</spage><epage>79</epage><pages>76-79</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>Abstract Objective A precise knowledge of the spread of botulinum toxin (BoNT) in muscle tissue is required to efficiently access endplate zones and increase BoNT's therapeutic efficacy. Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its modulating factors, such as injected volume and exercise after injection. Methods To visualize distribution in muscle tissue, sagittal, dynamic, balanced fast field echo (BFFE) MRI imaging was performed during injection of 1 ml BoNT/NaCl bolus in spastic biceps brachii muscles (SBB, n = 4), and 1 ml NaCl in the right and 2 ml NaCl in the left healthy biceps brachii (HBB, n = 6), with or without successive muscle exercise. The pattern of extracellular fluid distribution was evaluated by T2-weighted and diffusion tensor imaging (DTI) sequences. Results BFFE indicated an immediate increase in hyperintensity, parallel to the muscle fibers, in the shape of a long (5.3 ± 1.7 cm) and thin (0.52 ± 1.3 cm) layer in HBB. The layer in SBB was shorter (3.25 ± 0.6 cm, p = 0.01) and tended to be thicker (0.74 ± 2.9 cm, p = 0.27). In HBB, an increase in volume (2 ml) resulted in an increase in thickness (0.95 ± 0.2 cm, p = 0.015), but a consistent length (5.67 ± 1.3 cm, p = 0.54). DTI visualized a change of diffusion, which exceeded the bolus region by approximately 0.5 cm. Redistribution occurred 10 min after injection and was more prominent in HBB, compared to SBB. Additional muscle activity did not alter the diffusion pattern or bolus distribution. Conclusion Injecting BoNT at different depths perpendicular to the direction of the muscle fiber might optimize the efficacy of BoNT treatment. Additional sites along muscle fibers should be considered in SBB.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>25023196</pmid><doi>10.1016/j.jns.2014.06.028</doi><tpages>4</tpages></addata></record> |
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subjects | Adult Aged Botulinum toxin Botulinum Toxins - metabolism Botulinum Toxins - therapeutic use Diffusion Tensor Imaging Distribution Female Humans Injections, Intramuscular Magnetic Resonance Imaging Male Middle Aged MRI Muscle, Skeletal - drug effects Muscle, Skeletal - metabolism Neurology Neurotoxins - metabolism Neurotoxins - therapeutic use Spasm - drug therapy Spasm - pathology Spasticity Young Adult |
title | Intramuscular distribution of botulinum toxin—Visualized by MRI |
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