{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:02:25Z","timestamp":1792000945895,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014382","name":"Ipsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014382","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperkinetic movement disorders, including dystonia, tremor, and myoclonus, are disabling conditions often managed with botulinum toxin type A (BoNT\u2010A). Real\u2010world evidence on treatment patterns remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This nationwide, population\u2010based study aimed to evaluate trends in BoNT\u2010A use in France between 2015 and 2023, using the French National Hospital Discharge Database (\n                      <jats:italic>Programme de M\u00e9dicalisation des Syst\u00e8mes d'Information<\/jats:italic>\n                      , PMSI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were classified into four categories (dystonia, tremor, myoclonus, and other abnormal movements), based on International Classification of Diseases, 10th Revision (ICD\u201010). Annual changes in the number of BoNT\u2010A injections and treated patients were analyzed. Treatment adherence and reinjection intervals were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 51,861 patients received BoNT\u2010A therapy. Dystonia was the predominant indication (44,913; 86.6%). Tremor accounted for 3690 patients (7.1%), other abnormal movements for 2423 (4.7%), and myoclonus for 835 (1.6%). Between 2015 and 2023, BoNT\u2010A injections increased from 49,829 to 53,828 (+8.0%) and treated patients from 20,023 to 21,489 (+7.3%). While dystonia showed minimal growth in patient numbers (+0.6%), tremor and myoclonus increased substantially (+132.1% and +179.7%, respectively). Repeat BoNT\u2010A injections were highest in dystonia, with 71.8% of patients receiving \u22653 injections and 57.9% receiving \u22655 injections in total. Median reinjection intervals ranged from 112\u2009days in dystonia to 133\u2009days in myoclonus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dystonia remains the leading indication for BoNT\u2010A in France, with high treatment adherence. The marked growth in tremor and myoclonus underscores the expanding therapeutic role and diversification of BoNT\u2010A use across hyperkinetic movement disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70650","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:29:31Z","timestamp":1779686971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010World Patterns of Botulinum Toxin Treatment in Hyperkinetic Movement Disorders: A 9\u2010Year Nationwide Analysis in France"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-0410","authenticated-orcid":false,"given":"Marion","family":"Simonetta\u2010Moreau","sequence":"first","affiliation":[{"name":"Department of Neurosciences University Hospital of Toulouse France, INSERM, UMR1214 Toulouse France, Health Department of Toulouse University  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0631-8541","authenticated-orcid":false,"given":"Pierre","family":"Karam","sequence":"additional","affiliation":[{"name":"PKCS  Ecully France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Forestier","sequence":"additional","affiliation":[{"name":"Ipsen  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5644-1292","authenticated-orcid":false,"given":"Bertrand","family":"Degos","sequence":"additional","affiliation":[{"name":"Neurology Department, Avicenne Hospital, APHP H\u00f4pitaux Universitaires de Paris\u2010Seine Saint Denis (HUPSSD), Sorbonne Paris Nord, NS\u2010PARK\/FCRIN Network  Bobigny France"},{"name":"Center for Interdisciplinary Research in Biology, Coll\u00e8ge de France, CNRS UMR7241\/INSERM U1050 Universit\u00e9 PSL  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70183-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25475"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.659805"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23088"},{"issue":"2","key":"e_1_2_11_6_1","article-title":"Classification of dystonia","volume":"12","author":"Biase L","year":"2022","journal-title":"Life (Basel)"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5334\/tohm.185"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.4103\/0028-3886.226441","article-title":"Botulinum toxin in movement disorders","volume":"66","author":"Tater P","year":"2018","journal-title":"Neurol 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