{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:59:41Z","timestamp":1793224781633,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013733","name":"Ipsen Biopharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013733","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013116","name":"Merz Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013116","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of the study was the analysis of adherence and self\u2010perceived treatment response to long\u2010term botulinum neurotoxin type A (BoNT\u2010A) treatment in different neurological indications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective, monocentric, observational study, cross\u2010sectional and longitudinal data of 1351 patients documenting 20705 injection appointments at the BoNT outpatient clinic of Heinrich Heine University Duesseldorf between 1989 and 2014 were retrospectively analyzed. Patients had been treated with BoNT for neurological conditions, including cervical dystonia (CD), blepharospasm (BSP), other dystonia (ODT), hemifacial spasm (HFS), and spasticity (SPAS). The parameters longitudinally analyzed for the entire cohort were therapy duration as well as the mean and cumulative BoNT\u2010A dose. Cross\u2010sectionally, for subgroups of at least 721, patients\u2019 global self\u2010perceived quality of health and life, global self\u2010perceived reduction of symptoms by BoNT\u2010A treatment as well as the clinical global impression were evaluated. Furthermore, mouse hemidiaphragm assay antibodies (MHDA\u2010ABs) were analyzed in a subgroup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean treatment duration was 4.58\u00a0years (95% CI 4.32\u20134.84), and 678 (50.2%) therapy dropouts of 1351 patients occurred within the first 8\u00a0years. Therapy adherence and self\u2010perceived symptom reduction in long\u2010term BoNT\u2010A treatment over the years were significantly longer in BSP, HFS, and CD patients than in ODT and SPAS patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The treatment indication determines long\u2010term adherence and self\u2010perceived symptom reduction in BoNT\u2010A therapy, which are better in BSP, HFS, and CD patients than in ODT and SPAS patients. MHDA\u2010ABs had a significant impact on global self\u2010perceived symptom reduction, but with only a limited degree.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51225","type":"journal-article","created":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T23:38:34Z","timestamp":1606865914000},"page":"15-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Long\u2010term adherence and response to botulinum toxin in different indications"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-0216","authenticated-orcid":false,"given":"John\u2010Ih","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology Medical Faculty Heinrich Heine University D\u00fcsseldorf Moorenstrasse 5 D\u00fcsseldorf D\u201040225 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