{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T00:57:59Z","timestamp":1793581079756,"version":"4.5.0"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"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>This observational study aimed at investigating pain in stroke patients with upper limb spastic dystonia. Forty-one consecutive patients were enrolled. A 0\u201310 numeric rating scale was used to evaluate pain at rest and during muscle tone assessment. Patients were asked to indicate the most painful joint at passive mobilization (shoulder, elbow, wrist-fingers). The DN4 questionnaire was administered to disclose neuropathic pain. All patients were assessed just before and 1 month after incobotulinumtoxin-A treatment. Pain was present in 22 patients, worsened or triggered by passive muscle stretching. DN4 scored &lt; 4 in 20 patients. The most painful joints were wrist\u2013fingers in 12 patients, elbow in 5 patients and shoulder in the remaining 5 patients. Both elbow and wrist\u2013fingers pain correlated with muscle tone. BoNT-A treatment reduced pain in all the joints, including the shoulder. We discussed that nociceptive pain is present in a vast proportion of patients with upper limb spastic dystonia. BoNT-A treatment reduced both spastic dystonia and pain in all the joints but the shoulder, where the effect on pain could be mediated by the reduction of pathological postures involving the other joints.<\/jats:p>","DOI":"10.3390\/toxins14010039","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T23:35:09Z","timestamp":1641771309000},"page":"39","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effectiveness of Botulinum Toxin on Pain in Stroke Patients Suffering from Upper Limb Spastic Dystonia"],"prefix":"10.3390","volume":"14","author":[{"given":"Carlo","family":"Trompetto","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"},{"name":"IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Neurorehabilitation, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0620-7654","authenticated-orcid":false,"given":"Lucio","family":"Marinelli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"},{"name":"IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"},{"name":"IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Neurorehabilitation, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Puce","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Avanti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Saretti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Biasotti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Amella","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Cotellessa","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children\u2019 s Sciences (DINOGMI), Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico A.","family":"Restivo","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medicine, Garibaldi Hospital, 95127 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7945-8342","authenticated-orcid":false,"given":"Antonio","family":"Curr\u00e0","sequence":"additional","affiliation":[{"name":"Academic Neurology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04019 Terracina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"ref_1","first-page":"525","article-title":"Italian Spasticity Study Group Management of Stroke Patients Submitted to Botulinum Toxin Type A Therapy: A Delphi Survey of an Italian Expert Panel of Specialist Injectors","volume":"50","author":"Franceschini","year":"2014","journal-title":"Eur. 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