{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:45:00Z","timestamp":1788871500806,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T00:00:00Z","timestamp":1406160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001254","name":"Ipsen Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001254","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"\n Background and purpose<\/jats:title>\n \n Cervical dystonia (\n CD<\/jats:styled-content>\n ) patients usually receive repeated botulinum neurotoxin (Bo\n NT<\/jats:styled-content>\n ) injections. The aims of this study were to evaluate the feasibility of motor endplate zone (\n MEZ<\/jats:styled-content>\n ) detection of relevant cervical muscles in\n CD<\/jats:styled-content>\n patients receiving chronic Bo\n NT<\/jats:styled-content>\n treatment and to compare the treatment effect of half\u2010dosed, endplate\u2010targeted injections to standard Bo\n NT<\/jats:styled-content>\n injections.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In study 1, high\u2010density surface electromyography (HD\u2010sEMG) was recorded from the sternocleidomastoid (\n SCM<\/jats:styled-content>\n ) and splenius capitis (\n SC<\/jats:styled-content>\n ) muscles in 18\n CD<\/jats:styled-content>\n patients with ongoing Bo\n NT<\/jats:styled-content>\n treatment, by which the location of the\n MEZ<\/jats:styled-content>\n was determined. In study 2, nine additional patients with rotational\u2010type\n CD<\/jats:styled-content>\n participated in a treatment effect study where they received either half of their regular Bo\n NT<\/jats:styled-content>\n dose through endplate\u2010targeted injections or their normal Bo\n NT<\/jats:styled-content>\n dose through standard injections (crossover design). Dystonia severity was recorded before and 4\u00a0weeks after each treatment session (\n Toronto Western Spasmodic Torticollis Rating Scale<\/jats:styled-content>\n severity subscore).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the\n SCM<\/jats:styled-content>\n muscle the\n MEZ<\/jats:styled-content>\n was located at the lower border of the superior third part of the muscle, and in the\n SC<\/jats:styled-content>\n muscle at half muscle length. Endplate\u2010targeted, half\u2010dosed Bo\n NT<\/jats:styled-content>\n injection resulted in a similar treatment effect to injecting the full dose in the standard technique.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Half\u2010dosed, endplate\u2010targeted BoNT injections lead to a similar treatment effect to the standard BoNT injection protocol. MEZ detection confronts the clinician with some technical challenges, such as the ability of accurate and technically optimal placement of the electrode grid and correct interpretation of the\n HD\u2010sEMG<\/jats:styled-content>\n signal.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ene.12517","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T07:08:10Z","timestamp":1406185690000},"page":"1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The clinical utility of botulinum toxin injections targeted at the motor endplate zone in cervical dystonia"],"prefix":"10.1111","volume":"21","author":[{"given":"C. C. S.","family":"Delnooz","sequence":"first","affiliation":[{"name":"Department of Neurology Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. C.","family":"Veugen","sequence":"additional","affiliation":[{"name":"Department of Neurology Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands"},{"name":"Department of Biophysics Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W.","family":"Pasman","sequence":"additional","affiliation":[{"name":"Department of Neurology Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. G.","family":"Lapatki","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Centre Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Centre Ulm Ulm Germany"},{"name":"Kempenhaeghe Expertise Centre for Epileptology, Sleep Medicine and Neurocognition Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. P. C.","family":"van de Warrenburg","sequence":"additional","affiliation":[{"name":"Department of Neurology Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.41.7.1088"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6510-x"},{"key":"e_1_2_8_4_1","article-title":"Botulinum toxin type A therapy for cervical dystonia","volume":"1","author":"Costa J","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.4.1158"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2009.03.020"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90732-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000141129.23219.42"},{"key":"e_1_2_8_9_1","volume-title":"Anatomical Guide for the Electromyographer: The Limbs and Trunk","author":"Delagi EF","year":"1980"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2011.04.012"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.04.030"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2011.06.016"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2174\/157488606777934431"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00867425"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880120504"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2010.11.018"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10358"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00265.2005"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(83)90171-2"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.42.4.878"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1382"},{"issue":"1","key":"e_1_2_8_22_1","first-page":"445","article-title":"The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS): assessment of validity and inter\u2010rater reliability","volume":"40","author":"Consky E","year":"1990","journal-title":"Neurology"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(01)00708-8"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-010-0729-y"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21724"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20403"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870120115"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.12517","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.12517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T18:41:32Z","timestamp":1695494492000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.12517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,24]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1111\/ene.12517"],"URL":"https:\/\/doi.org\/10.1111\/ene.12517","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,24]]},"assertion":[{"value":"2014-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-05-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}