2026-04-17T20:13:41Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/135932025-10-24T08:29:00Zcom_2072_451660com_2072_378040col_2072_451662

Ultrasound-Guided Botulinum Toxin Infiltrations in Essential Tremor Patients: A 36-week Follow Up Salazar, Gabriel Caballero, Iolanda Servei de Neurologia, Consorci Sanitari de Terrassa (CST), Terrassa, Spain Departament de Salut Tremolor Toxina botulínica Espasticitat DISEASES::Nervous System Diseases::Central Nervous System Diseases::Movement Disorders::Essential Tremor DISEASES::Musculoskeletal Diseases::Muscular Diseases::Muscle Spasticity CHEMICALS AND DRUGS::Enzymes and Coenzymes::Enzymes::Hydrolases::Peptide Hydrolases::Endopeptidases::Metalloendopeptidases::Botulinum Toxins Other subheadings::Other subheadings::/drug effects ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::trastornos del movimiento::temblor esencial ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades musculares::espasticidad muscular COMPUESTOS QUÍMICOS Y DROGAS::enzimas y coenzimas::enzimas::hidrolasas::péptido hidrolasas::endopeptidasas::metaloendopeptidasas::toxinas botulínicas Otros calificadores::Otros calificadores::/efectos de los fármacos Botulinum toxin; Essential tremor; Ultrasound-guided injection Toxina botulínica; Tremolor essencial; Infiltració guiada per ecografia Toxina botulínica; Temblor esencial; Infiltración guiada por ecografía Essential tremor (ET) presents therapeutic challenges as oral therapies, are often partially effective and carry adverse effects. Deep Brain Stimulation and High-intensity Focused Ultrasound targeting the ventral intermediate thalamic nucleus show efficacy in managing ET; however, their cost and invasiveness deter some patients. Botulinum toxin infiltrations for ET in the upper limbs have been limited by adverse effects. Most studies used manual or electromyography guidance, while ultrasound guidance has been less explored. The purpose of the present study was to investigate the potential long-term improvement in tremor and quality of life among ET patients following ultrasound-guided IncobotulinumtoxinA (IncoBoNT) infiltrations. We present 18 ET patients who received IncoBoNT injections guided by ultrasounds. We also propose an anatomo-physiological paradigm for targeting muscles in ET patients based on two different tremor patterns. Eighteen ET patients (mean age 68.2 years) were followed over 12 months. After 36 weeks, patients with supination/pronation (SPP) and flexion/extension (FEP) patterns showed significant TETRAS score improvements: 46.4% in SPP (p = 0.0022) and 48.2% in FEP (p = 0.0021). The QUEST-QOL score also improved (65% in SPP, p = 0.0018; 62.7% in FEP, p = 0.0018). All patients presented notable improvements in mean scores on the self-evaluating spiral test and neurophysiological measures (p < 0.01 for all). Treatment effects lasted 8-12 weeks, with temporary numbness and pain reported, and no cumulative effects observed. Ultrasound-guided IncoBoNT infiltrations show promise for oral treatment-resistant ET patients with minimal adverse effects. The anatomophysiological paradigm utilized proved beneficial for our patients, although tremor pattern variability remains a consideration. Essential tremor patients often face limited options, as oral therapies often yield only partial efficacy, and invasive interventions, like Deep Brain Stimulation, may not always be viable. In this open-label study, 18 patients received ultrasound-guided IncobotulinumtoxinA injections, showing significant tremor improvement and enhanced quality of life, with minimal adverse events reported. This research was partially funded by Merz Therapeutics Iberia. The authors independently designed and conducted the study. No representatives from Merz Therapeutics Iberia participated in the collection, management, analysis, or interpretation of the data or in preparation, review, or approval of the manuscript. 2025-09-03T10:38:32Z 2025-09-03T10:38:32Z 2025-03-03 info:eu-repo/semantics/article Salazar G, Caballero I. Ultrasound-Guided Botulinum Toxin Infiltrations in Essential Tremor Patients: A 36-week Follow Up. Tremor Other Hyperkinet Mov (N Y). 2025 Mar 3;15:8. 2160-8288 http://hdl.handle.net/11351/13593 10.5334/tohm.957 40060174 http://hdl.handle.net/11351/13593 eng Tremor and Other Hyperkinetic Movements;15(1) https://www.doi.org/10.5334/tohm.957 Attribution-NonCommercial 4.0 International https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Ubiquity Press Scientia