{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T19:34:11Z","timestamp":1773862451986,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum D\u00fcsseldorf. Anstalt \u00f6ffentlichen Rechts"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Repeated injections with abo- or onabotulinumtoxin type A (aboBoNT\/A, onaBoNT\/A) may lead to induction of neutralizing antibodies (NABs) and\/or a secondary treatment failure (STF). The relation between NABs and STF is still unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim of the study<\/jats:title>\n                <jats:p>To demonstrate that a significant improvement can be observed in patients with STF after abo- or onaBoNT\/A-treatment when switched to incobotulinumtoxin type A (incoBoNT\/A) and that in NAB-positive patients without STF abo- or onaBoNT\/A-treatment can be continued without significant worsening.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Paralysis times (PT) of the mouse hemidiaphragm assay (MHDA) and clinical outcome (TSUI-score) was analyzed in 60 patients with cervical dystonia (CD) and STF after abo- or onaBoNT\/A-treatment (STF-group) who were switched to incobotulinumtoxin type A (incoBoNT\/A). These data were compared to those of 34 patients who were exclusively treated with incoBoNT\/A (INCO-group). Furthermore, PTs and TSUI-scores were followed up over 7\u00a0years in 9 patients with NABs but without STF who were switched to inco-BoNT\/A (SWI-group) and 9 other patients with NABs who remained on their previous BoNT\/A preparation (NO-SWI-group).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In the STF-group, a significant improvement of TSUI-scores could be detected after switch to incoBoNT\/A. This improvement was less pronounced than in the INCO-group. There was no significant difference in long-term outcome between the SWI- and NO-SWI-group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The best strategy is to avoid the induction of NABs. A switch to incoBoNT\/A may lead to improvement in patients with STF. However, in some patients with NABs without STF, BoNT\/A-treatment can be continued without significant worsening.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-022-11235-3","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T09:02:26Z","timestamp":1658048546000},"page":"5991-6002","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The complex relationship between antibody titers and clinical outcome in botulinum toxin type A long-term treated patients with cervical dystonia"],"prefix":"10.1007","volume":"269","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":"Beyza","family":"\u00dcrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphaela","family":"Brauns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven G.","family":"Meuth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John-Ih","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Albrecht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Samadzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,17]]},"reference":[{"key":"11235_CR1","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1212\/WNL.0000000000002560","volume":"86","author":"DM Simpson","year":"2016","unstructured":"Simpson DM, Hallett M, Ashman EJ et al (2016) Practice guideline update summary: botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: report of the Guideline Development Subcommittee of the American Academy of Neurology. 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This study has been supported by a restricted grant of the Inge-Diesbach Stiftung to prof. Harald Hefter. This grant did not have influence on the design and content of the present study. He declares no other disclosures relevant for the manuscript. Sven G Meuth has received honoraria for lecturing and travel expenses for attending meetings from Almirall, Amicus Therapeutics Germany, Bayer Health Care, Biogen, Celgene, Diamed, Genzyme, MedDay Pharmaceuticals, Merck Serono, Novartis, Novo Nordisk, ONO Pharma, Roche, Sanofi-Aventis, Chugai Pharma, QuintilesIMS, and Teva. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), Else Kr\u00f6ner Fresenius Foundation, German Academic Exchange Service, Hertie Foundation, Interdisciplinary Center for Clinical Studies (IZKF) Muenster, German Foundation Neurology, and by Almirall, Amicus Therapeutics Germany, Biogen, Diamed, Fresenius Medical Care, Genzyme, Merck Serono, Novartis, ONO Pharma, Roche, and Teva. John-Ih Lee has received honoraria for speaking\/consultation from Bayer Healthcare, Boehringer Ingelheim, Allergan, Novartis, Ipsen, Teva, and Daiichi-Sankyo, as well as travel grants from Bayer Healthcare, Merz, Allergan, and Ipsen, outside the submitted work. Philipp Albrecht received a research grant form Ipsen Pharma to support the analysis of the data of patients with spasticity and a grant from Merz Pharmaceuticals for funding of NAB-testing. Besides this, he reports grants, personal fees and non-financial support from Allergan, Biogen, Ipsen, Merz Pharmaceuticals, Merck, Novartis, and Roche, personal fees and non-financial support from Bayer Healthcare, and non-financial support from Sanofi-Aventis\/Genzyme, outside the submitted work.","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":"Ethical 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"}}]}}