{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T19:58:20Z","timestamp":1782331100928,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Symptom re\u2010emergence before re\u2010injection negatively impacts cervical dystonia (CD) patients receiving botulinum toxin type A (BoNT\u2010A) therapy. Longer waning time is associated with abobotulinumtoxinA (abo\u2010BoNT\u2010A) as compared to onabotulinumtoxinA (ona\u2010BoNT\u2010A)\/incobotulinumtoxinA (inco\u2010BoNT\u2010A) formulations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare waning time and treatment outcomes when chronically injected CD patients experiencing early waning despite being optimized on BoNT\u2010A (ona\u2010BoNT\u2010A\/inco\u2010BoNT\u2010A) were converted to abo\u2010BoNT\u2010A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010three chronically injected CD participants with a waning time of \u22648\u2009weeks were converted to abo\u2010BoNT\u2010A (1:2.5 dose ratio) for three injections every 12\u2010weeks. The second and third injection patterns were kinematically optimized. Participants were converted back to their original BoNT\u2010A for the fourth injection (1:2.5) using the same third abo\u2010BoNT\u2010A pattern. Participant\u2010perceived waning times were collected post\u2010injections. Clinical scales (Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)) and kinematic measures were collected 12\u2010weeks post\u2010injection and at three peak effect time\u2010points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to baseline, waning time (12\u201322\u2009days) significantly increased following all abo\u2010BoNT\u2010A treatments (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.005) but was not significantly different at the fourth injection (original BoNT\u2010A reconversion). TWSTRS sub\u2010scores significantly reduced following all abo\u2010BoNT\u2010A treatments (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and at peak effect following the third injection compared to original BoNT\u2010A. Dysphagia and muscle weakness were reported and comparable to safety of original BoNT\u2010A formulations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Optimized patients experiencing waning had significant improvement in the peak benefit as well as the duration of effect when converted to abo\u2010BoNT\u2010A. This effect was toxin dependent as reconversion to the original BoNT\u2010A using the kinematically optimized pattern failed to produce an improvement in waning.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13696","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T00:14:17Z","timestamp":1675988057000},"page":"756-763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Conversion to <scp>AbobotulinumtoxinA<\/scp> Increases Waning Time and Efficacy for Cervical Dystonia"],"prefix":"10.1002","volume":"10","author":[{"given":"Olivia","family":"Samotus","sequence":"first","affiliation":[{"name":"Department of Clinical Neurological Sciences London Health Sciences Centre\u2014Lawson Health Research Institute  London Ontario Canada"},{"name":"Schulich School of Medicine and Dentistry University of Western  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandar","family":"Jog","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences London Health Sciences Centre\u2014Lawson Health Research Institute  London Ontario Canada"},{"name":"Schulich School of Medicine and Dentistry University of Western  London Ontario 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