{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:38:54Z","timestamp":1740109134647,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neural Transm"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Botulinum toxin (BT) has been successfully used for many years to treat various muscle hyperactivity disorders including dystonia and spasticity. Its dosing is guided by dosing tables describing target muscles and dose ranges. To refine the BT dosing, we wanted to analyse how contextual factors may influence the injector's final dosing decision.<\/jats:p><jats:p>In a retrospective review of real-life data of 1170 BT treatments, we studied the influence of various contextual factors on the BT doses in 21 arm muscles of 252 patients receiving BT therapy for different muscle hyperactivity disorders.<\/jats:p><jats:p>We found that BT arm doses are significantly higher in treatment of spasticity than in treatment of dystonia. We also found that spontaneous arm dystonia requires higher BT doses in a proximal application pattern, whereas task specific writer's cramp requires considerably reduced BT doses with a distal application pattern. Injections of non-arm muscles influence the BT dosing in arm muscles only marginally.<\/jats:p><jats:p>Our study demonstrates that BT dosing does not only depend on the particularities of the individual target muscle injected, such as its volume and its static or phasic function. BT dosing and its application pattern rather depend on additional contextual factors such as the aetiology and pathophysiology of the muscle hyperactivity treated. These contextual factors need to be included in dosing tables and may improve the outcome of BT therapy.<\/jats:p>","DOI":"10.1007\/s00702-021-02307-1","type":"journal-article","created":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T13:02:49Z","timestamp":1612011769000},"page":"315-319","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Botulinum toxin dosing in arm muscles: contextual factors"],"prefix":"10.1007","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3612-3796","authenticated-orcid":false,"given":"Dirk","family":"Dressler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Kopp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fereshte","family":"Adib Saberi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,30]]},"reference":[{"key":"2307_CR1","volume-title":"Botulinum Toxin Therapy","author":"D Dressler","year":"2000","unstructured":"Dressler D (2000) Botulinum Toxin Therapy. Thieme, Stuttgart"},{"issue":"Suppl 2","key":"2307_CR2","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1111\/j.1468-1331.2009.02877.x","volume":"16","author":"D Dressler","year":"2009","unstructured":"Dressler D (2009) Routine use of Xeomin\u00ae in patients pre-treated with Botox\u00ae. Eur J Neurol 16(Suppl 2):2\u20135","journal-title":"Eur J Neurol"},{"key":"2307_CR3","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s00702-010-0372-0","volume":"117","author":"D Dressler","year":"2010","unstructured":"Dressler D (2010) Comparing Botox\u00ae and Xeomin\u00ae for the treatment of axillar hyperhidrosis. J Neural Transm 117:317\u2013319","journal-title":"J Neural Transm"},{"key":"2307_CR4","doi-asserted-by":"publisher","DOI":"10.1017\/9781316459324","volume-title":"Treatment of Dystonia","author":"D Dressler","year":"2018","unstructured":"Dressler D (2018) Dosing Schemes for Botulinum Toxin Therapy of Dystonia. In: Dressler D, Altenm\u00fcller E, Krauss JK (eds) Treatment of Dystonia. Cambridge University Press, Cambridge"},{"key":"2307_CR5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s00702-011-0719-1","volume":"119","author":"D Dressler","year":"2012","unstructured":"Dressler D, Mander G, Fink K (2012) Measuring the potency labelling of onabotulinumtoxinA (Botox\u00ae) and Xeomin\u00ae in an LD50 assay. J Neural Transm 119:13\u201315","journal-title":"J Neural Transm"},{"key":"2307_CR6","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s00702-014-1252-9","volume":"122","author":"D Dressler","year":"2014","unstructured":"Dressler D, Adib Saberi F, Kollewe K, Schrader C (2014a) Safety aspects of incobotulinumtoxinA high dose therapy. J Neural Transm 122:327\u2013333","journal-title":"J Neural Transm"},{"key":"2307_CR7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00702-013-1076-z","volume":"121","author":"D Dressler","year":"2014","unstructured":"Dressler D, Tacik P, Adib Saberi F (2014b) Botulinum toxin therapy of cervical dystonia: Comparing Botox\u00ae and Xeomin\u00ae. J Neural Transm 121:29\u201331","journal-title":"J Neural Transm"},{"key":"2307_CR8","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1007\/s00415-016-8304-z","volume":"264","author":"D Dressler","year":"2017","unstructured":"Dressler D, Bhidayasiri R, Bohlega S, Chahidi A, Mo Chung T, Ebke M, Jacinto LJ, Kaji R, Ko\u00e7er S, Kanovsky P, Micheli F, Orlova O, Paus S, Pirtosek Z, Relja M, Rosales RL, Sag\u00e1stegui-Rodr\u00edguez JA, Schoenle PW, Shahidi GA, Timerbaeva S, Walter U, Adib Saberi F (2017) Botulinum toxin therapy for treatment of spasticity in multiple sclerosis: review and recommendations of the IAB - interdisciplinary working group for movement disorders task force. J Neurol 264:112\u2013120","journal-title":"J Neurol"},{"key":"2307_CR9","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1007\/s00702-018-1897-x","volume":"125","author":"D Dressler","year":"2018","unstructured":"Dressler D, Pan L, Bigalke H (2018) Comparing IncobotulinumtoxinA (Xeomin\u00ae) and OnabotulinumtoxinA (Botox\u00ae): Identical Potency Labelling in the Hemidiaphragm Assay. J Neural Transm 125:1351\u20131354","journal-title":"J Neural Transm"},{"key":"2307_CR10","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1212\/WNL.0000000000003789","volume":"88","author":"J Wissel","year":"2017","unstructured":"Wissel J, Bensmail D, Ferreira J, Molteni F, Satkunam L, Moraleda S, Rekand T, McGuire J, Scheschonka A, Flatau-Baqu\u00e9 B, Simon O, Dressler D, Simpson DM (2017) Safety and efficacy of incobotulinumtoxinA doses up to 800 U in spasticity: the TOWER study. Neurology 88:1321\u20131328","journal-title":"Neurology"}],"container-title":["Journal of Neural Transmission"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00702-021-02307-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00702-021-02307-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00702-021-02307-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T07:03:39Z","timestamp":1615964619000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00702-021-02307-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,30]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["2307"],"URL":"https:\/\/doi.org\/10.1007\/s00702-021-02307-1","relation":{},"ISSN":["0300-9564","1435-1463"],"issn-type":[{"type":"print","value":"0300-9564"},{"type":"electronic","value":"1435-1463"}],"subject":[],"published":{"date-parts":[[2021,1,30]]},"assertion":[{"value":"8 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}