{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:23:07Z","timestamp":1760239387804,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Botulinum toxin type B (BoNT\/B) has been recommended as an alternative for patients who have become resistant to botulinum toxin type A (BoNT\/A). This study aimed to compare the clinical effect, within a patient, of four injections with low doses of rimabotulinumtoxinB with the effect of the preceding abobotulinumtoxinA (aboBoNT\/A) injections. In 17 patients with cervical dystonia (CD) who had become resistant to aboBoNT\/A, the clinical effect of the first four rimabotulinumtoxinB (rimaBoNT\/B) injections was compared to the effect of the first four aboBoNT\/A injections using a global assessment scale and the TSUI score. After the first two BoNT\/B injections, all 17 patients responded well and to a similar extent as to the first two BoNT\/A injections, but with more side effects such as dry mouth and constipation. After the next BoNT\/B injection, the improvement started to decline. The response to the fourth BoNT\/B injection was significant (p &lt; 0.048) lower than the fourth BoNT\/A injection. Only three patients developed a complete secondary treatment failure (CSTF) and five patients a partial secondary treatment failure (PSTF) after four BoNT\/B injections. In nine patients, the usual response persisted. With the use of low rimaBoNT\/B doses, the induction of CSTF and PSTF to BoNT\/B could not be avoided but was delayed in comparison to the use of higher doses. In contrast to aboBoNT\/A injections, PSTF and CSTF occurred much earlier, although low doses of rimaBoNT\/B had been applied.<\/jats:p>","DOI":"10.3390\/toxins12110677","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T23:06:12Z","timestamp":1604012772000},"page":"677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-7684","authenticated-orcid":false,"given":"Harald","family":"Hefter","sequence":"first","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstra\u00dfe 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-1852","authenticated-orcid":false,"given":"Sara","family":"Samadzadeh","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstra\u00dfe 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Moll","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstra\u00dfe 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1016\/S0161-6420(80)35127-0","article-title":"Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery","volume":"87","author":"Scott","year":"1980","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ene.13762","article-title":"Dystonia: Diagnosis and management","volume":"26","author":"Albanese","year":"2018","journal-title":"Eur. 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