Botulinum toxin for hereditary spastic paraplegia: effects on motor and non-motor manifestations

• Published in: Arquivos de neuro-psiquiatria Vol. 76; no. 3; pp. 183 - 188
• Main Authors: Servelhere, Katiane R., Faber, Ingrid, Martinez, Alberto, Nickel, Renato, Moro, Adriana, Germiniani, Francisco M. B., Moscovich, Mariana, Blume, Tatiane R., Munhoz, Renato P., Teive, Hélio A. G., França, Marcondes C.
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-03-2018; Arquivos de Neuro-Psiquiatria; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Adult; Age of Onset; Botulinum toxin; Botulinum toxin type A; Botulinum Toxins, Type A - therapeutic use; Coxa; espasticidade muscular; Fatigue; Female; Gait; Gait - drug effects; Gait - physiology; Genotypes; Hereditary spastic paraplegia; Humans; Injections, Intramuscular; Male; Middle Aged; Motor Disorders - drug therapy; Motor Disorders - physiopathology; Muscle Fatigue - drug effects; Muscle Fatigue - physiology; Muscle Spasticity - drug therapy; Muscle Spasticity - physiopathology; Muscles; Neuromuscular Agents - therapeutic use; NEUROSCIENCES; Paralysis; paraparesia espástica hereditária; Patients; Phenotypes; PSYCHIATRY; Reproducibility of Results; Spastic Paraplegia, Hereditary - drug therapy; Spastic Paraplegia, Hereditary - physiopathology; Spasticity; toxinas botulínicas; Treatment Outcome; botulinum toxin; spastic paraplegia; muscle spasticity; paraparesia espástica hereditária; toxinas botulínicas; hereditary; espasticidade muscular
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282X20180013

ABSTRACT
Motor and non-motor manifestations are common and disabling features of hereditary spastic paraplegia (HSP). Botulinum toxin type A (Btx-A) is considered effective for spasticity and may improve gait in these patients. Little is known about the effects of Btx-A on non-motor symptoms in HSP patients.
Objective
To assess the efficacy of Btx-A on motor and non-motor manifestations in HSP patients.
Methods
Thirty-three adult patients with a clinical and molecular diagnosis of HSP were evaluated before and after Btx-A injections.
Results
Mean age was 41.7 ± 13.6 years and there were 18 women. Most patients had a pure phenotype and
SPG4
was the most frequent genotype. The Btx-A injections resulted in a decrease in spasticity at the adductor muscles, and no other motor measure was significantly modified. In contrast, fatigue scores were significantly reduced after Btx-A injections.
Conclusion
Btx-A injections resulted in no significant functional motor improvement for HSP, but fatigue improved after treatment.