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Intrafusal effects of botulinum toxin in post‐stroke upper limb spasticity
Author(s) -
Trompetto C.,
Bove M.,
Avanzino L.,
Francavilla G.,
Berardelli A.,
Abbruzzese G.
Publication year - 2008
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2008.02076.x
Subject(s) - spasticity , medicine , tonic (physiology) , botulinum toxin , physical medicine and rehabilitation , stroke (engine) , wrist , stretch reflex , reflex , modified ashworth scale , electromyography , anesthesia , anatomy , mechanical engineering , engineering
A previous study in subjects with focal dystonia suggested that the greater and longer‐lasting effect induced by botulinum toxin type A (BoNT‐A) on the tonic vibration reflex (TVR) than on the maximal M‐wave (M‐max) might be the physiological marker of the toxin’s action at the level of intrafusal muscle fibres. With this approach, we investigated the possible effect of BoNT‐A on fusimotor synapses in eight patients with post‐stroke spasticity (four with no residual motor capacity before treatment and four with partially spared muscle strength and residual motor capacity). TVR and M‐max were recorded from the wrist and finger flexor muscles before treatment and at 1, 4 and 7 months afterwards. The TVR reduction was greater than the M‐max reduction and remained fairly constant over time only in the subjects with a residual motor capacity before the treatment. This pilot study suggests that some degree of strength and active movement is necessary for the action of BoNT‐A on intrafusal fibres.