The painful ailment treated with local injections of botulinum toxin but today also the deep brain neuro-stimulation is used. One study compares the two therapies
Dystonia a movement disorder characterized by involuntary muscle contractions which force certain parts of the body, such as arms, legs, neck and face, to assume abnormal and often painful postures or movements. Since the 1980s it has been treated with local injections of botulinum toxinwhich causes a muscle relaxation. However, the deep brain neuro-stimulation, a technique derived from the treatment of Parkinson’s disease. Dystonia looks like a muscular disorder, but in reality it is the consequence of an altered programming of movement, one could say a disorder of the control software that is inside the brain, says Professor Alberto Albanese, head of the Neurology Operational Unit. ‘Humanitas Clinical Institute of Milan and President of the Scientific Committee of the Italian Association for Dystonia Research (ARD). Treatment with a pacemaker positioned in specific movement control centers in the brain, such as the pale globe, is able to increase the level of filtration of the excess stimulation that reaches the muscle. In practice, the pacemaker, by increasing the level of filtration of the stimuli, disturbs the production of involuntary movements that reach the muscle
I study
A common form of dystonia that affects the neck, the so-called cervical dystonia, and to this form that refers a study coordinated by Albanese and presented today during the third edition of the National Day of Dystonia (24 September 2022). This is a phase III randomized trial, funded by the Ministry of Health, carried out in collaboration between the Humanitas Clinical Institute and the University of Milan, which provides for a comparison of efficacy between botulinum toxin and deep brain neurostimulation, and which will also monitor, through positron emission tomography (PET), the changes in brain metabolism induced by the two treatments. The study will help us to understand in which cases one treatment or the other will be more suitable. There are no previous studies directly comparing the efficacy of botulinum toxin and deep neurostimulation, nor are there currently guidelines or specific indications to direct those suffering from cervical dystonia to one of the two treatments. Today botulinum toxin is considered the first choice treatment only because it is non-invasive, while deep neurostimulation initially requires neurosurgical intervention for the implantation of the pacemaker. But it is not known whether some forms of cervical dystonia could benefit more from neurostimulation.
What
According to data from the Italian Association for Research on Dystonia, chaired by Flavia Cogliati, in Italy there are many more patients with dystonia than the approximately twenty thousand officially recognized, since often this pathology confused with other disorders which may have some similar clinical features. Dystonia, which most affects women, can arise at all ages, although typically it develops between the ages of 40 and 60, generating considerable interference with work activities, despite the fact that the treatments available allow some control of the symptoms.
September 23, 2022 (change September 23, 2022 | 18:05)
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