Botulinum toxin type A for neuropathic pain in patients with spinal cord injury

被引:74
作者
Han, Zee-A [2 ]
Song, Dae Heon [1 ]
Oh, Hyun-Mi [3 ]
Chung, Myung Eun [1 ]
机构
[1] Catholic Univ Korea, Coll Med, St Pauls Hosp, Dept Rehabil Med, Wangsan Ro 180, Seoul, South Korea
[2] Catholic Univ Korea, Natl Rehabil Ctr, Dept Rehabil Med, Seoul, South Korea
[3] Catholic Univ Korea, Coll Med, Seoul St Marys Hosp, Dept Rehabil Med, Seoul, South Korea
关键词
BOWEL-SYNDROME PATIENTS; QUALITY-OF-LIFE; PLACEBO ANALGESIA; POSTHERPETIC NEURALGIA; SUBCUTANEOUS INJECTION; DOUBLE-BLIND; ACTIVATION; MECHANISMS; NEUROTOXIN; POTENTIATION;
D O I
10.1002/ana.24605
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
ObjectiveTo evaluate the analgesic effect of botulinum toxin type A (BTX-A) on patients with spinal cord injury-associated neuropathic pain. MethodsThe effect of BTX-A on 40 patients with spinal cord injury-associated neuropathic pain was investigated using a randomized, double-blind, placebo-controlled design. A 1-time subcutaneous BTX-A (200U) injection was administered to the painful area. Visual analogue scale (VAS) scores (0-100mm), the Korean version of the short-form McGill Pain Questionnaire, and the World Health Organization WHOQOL-BREF quality of life assessment were evaluated prior to treatment and at 4 and 8 weeks after the injection. ResultsAt 4 and 8 weeks after injection, the VAS score for pain was significantly reduced by 18.616.8 and 21.3 +/- 26.8, respectively, in the BTX-A group, whereas it was reduced by 2.6 +/- 14.6 and 0.3 +/- 19.5, respectively, in the placebo group. The pain relief was associated with preservation of motor or sensory function below the neurological level of injury. Among the responders in the BTX-A group, 55% and 45% reported pain relief of 20% or greater at 4 and 8 weeks, respectively, after the injection, whereas only 15% and 10% of the responders in the placebo group reported a similar level of pain relief. Improvements in the score for the physical health domain of the WHOQOL-BREF in the BTX-A group showed a marginal trend toward significance (p=0.0521) at 4 weeks after the injection. InterpretationThese results indicate that BTX-A may reduce intractable chronic neuropathic pain in patients with spinal cord injury. Ann Neurol 2016;79:569-578
引用
收藏
页码:569 / 578
页数:10
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