{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:08:20Z","timestamp":1740107300961,"version":"3.37.3"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The aim of study was to demonstrate that the first three injections of botulinum neurotoxin type A (BoNT\/A) appear to be less effective in botulinum toxin na\u00efve patients with idiopathic cervical dystonia (CD) with mild symptoms and low severity scores (TSUI-scores) at onset of BoNT\/A-therapy compared to patients with full-blown CD and high initial TSUI-scores.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In 337 patients with CD who started BoNT\/A-therapy in the BoNT-outpatient clinic of the university hospital in D\u00fcsseldorf during the last 12 years, demographical and treatment-related data as well as outcome measures (TSUI-scores) of the first four visits were extracted from the treatment ACCESS data bank.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Distribution of the severity of CD scored using the TSUI-score significantly changed with the first three injections. In patients with a high baseline severity (TSUI-score\u2009&gt;\u200910), mean TSUI-score continuously decreased (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas in patients with a low initial severity (TSUI-score\u2009&lt;\u20096), mean TSUI-score increased (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) during the first three injection cycles. Individual responses varied between 100% improvement, no response at all, and even worsening. Improvement of CD at the end of an injection cycle was observed in less than 25% in the mildly affected patients, but in more than 80% in the more severely affected patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Clinical response to the first three BoNT\/A-injections in severely affected de novo CD-patients is different from the response to BoNT\/A in mildly affected de novo CD-patients. This has implications for further scientific studies and the patient management of mildly affected de novo patients with cervical dystonia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-020-10128-7","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T18:02:40Z","timestamp":1596650560000},"page":"206-213","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The impact of the initial severity on later outcome: retrospective analysis of a large cohort of botulinum toxin na\u00efve patients with idiopathic cervical dystonia"],"prefix":"10.1007","volume":"268","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-7684","authenticated-orcid":false,"given":"Harald","family":"Hefter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Samadzazeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"10128_CR1","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1212\/WNL.55.1.2","volume":"55","author":"M Stacy","year":"2000","unstructured":"Stacy M (2000) Ideopathic cervical dystonia: an overview. 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This study has been supported by a restricted grant of the Inge-Diesbach Stiftung to prof. Harald Hefter. We would like to thank C. Fremersdorf for the extraction of the clinical relevant data from the ACCESS\u00ae data bank and the transfer into an EXEL\u00ae file for the final statistical analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The local ethics committee of the University of D\u00fcsseldorf allows publication of anonymized clinical data retrospectively extracted from patients\u2019 charts.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants gave informed consent to participate in all studies run by University Hospital Duesseldorf. And they also gave informed consent for publication any research work from their data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate\/consent for publication"}}]}}