{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:04:14Z","timestamp":1789718654297,"version":"4.0.1"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold><jats:italic>Background and Objective<\/jats:italic><\/jats:bold>Pain is a frequent symptom in Parkinson\u2019s disease (PD), and the therapeutic alternatives are scarce. The goal of this trial was to measure the effects of botulinum toxin type A (BTXA) in the treatment of limb pain in advanced PD.<jats:bold><jats:italic>Methods<\/jats:italic><\/jats:bold>A randomized double-blind crossover versus placebo study of BTXA for limb pain in advanced Parkinson\u2019s disease was conducted. Subjects received individualized BTXA\/placebo dosing per pain distribution in limbs. The primary outcome was a measure of change in global pain on a numeric rating scale (NRS) at 4 and 12 weeks postinjection and on a visual analogue scale 12 weeks after treatment. Secondary outcomes included the percentage of responders, physician-rated clinical global impressions, MDS\u2013UPDRS and PDQ\u201339 scores, and adverse events.<jats:bold><jats:italic>Results<\/jats:italic><\/jats:bold>A total of 12 subjects completed the trial. Treatment with BTXA (average dose=241.66 U) produced a significant reduction in NRS score 4 weeks after the injections (\u20131.75 points, range from \u20133 to 7,<jats:italic>p<\/jats:italic>=0.033). However, there was no significant difference compared to placebo (<jats:italic>p<\/jats:italic>=0.70). Participants with dystonic pain showed a greater reduction in NRS score after 4 weeks when treated with BTXA (2.66 points vs. 0.75 for placebo). There were no significant differences for any of the secondary outcomes or significant adverse events.<jats:bold><jats:italic>Conclusions<\/jats:italic><\/jats:bold>Targeted BTXA injections were safe in patients with limb pain and advanced PD; however, the present study failed to show a significant effect when compared to placebo. Further studies may be focused on evaluating the effect of BTXA particularly in dystonic pain.<\/jats:p>","DOI":"10.1017\/cjn.2017.245","type":"journal-article","created":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T03:47:00Z","timestamp":1510199220000},"page":"23-29","source":"Crossref","is-referenced-by-count":31,"title":["Botulinum Toxin Type A for Pain in Advanced Parkinson\u2019s Disease"],"prefix":"10.1017","volume":"45","author":[{"given":"Veronica","family":"Bruno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eliza","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Mancini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane 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