{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:23:08Z","timestamp":1771464188905,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"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>The motor behaviour of patients with Upper Motor Neuron Syndrome (UMNS) is characterised by spasticity. The first-line treatment for this clinical condition is Botulinum neurotoxin A (BoNTA), but the number and key locations of muscles which need to be treated is not much discussed in the literature. Cross-sectional analysis of outpatient cohort with UMNS spasticity, who were potential candidates for BoNTA treatment, was performed. Between November 2020 and November 2021, all consecutive adult patients eligible for BoNTA treatment were enrolled. The inclusion criteria encompass UMNS spasticity (onset being \u22656 months), with disabling muscles hypertonia. Patients underwent a clinical evaluation, a comprehensive assessment with the Modified Ashworth Scale, with the Modified Rankin Scale, and a patients\u2019 perception-centred questionnaire. In total, 68 participants were enrolled in the study, among them 40 (58.8%) were male; mean age 57.9 \u00b1 15.1. In women, BoNTA was more frequently required for adductor group muscles, independently from potential confounders (OR = 7.03, 95%CI: 1.90\u201325.97). According to the pattern of disability, patients with hemiparesis more frequently need to be treated in the upper limb, whereas the diplegia\/double-hemiparesis group needed to be treated more frequently at the adductor and crux muscles compared to their counterparts. UMNS spasticity in women could require more attention to be paid to the treatment of adductor muscle spasticity, potentially because the dysfunction of those muscles could influence sphincteric management, required for perineal hygiene and\/or sexual life.<\/jats:p>","DOI":"10.3390\/toxins14040246","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T21:24:42Z","timestamp":1648675482000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Observational Cross-Sectional Study of Gender and Disability as Determinants of Person-Centered Medicine in Botulinum Neurotoxin Treatment of Upper Motoneuron Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2483-7959","authenticated-orcid":false,"given":"Cristina Maria","family":"Del Prete","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, ASL, 73100 Lecce, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia Giuseppe","family":"Viva","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopaedics, Sapienza University of Rome, 00183 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"De Trane","sequence":"additional","affiliation":[{"name":"Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), ICS Maugeri, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8950-8203","authenticated-orcid":false,"given":"Fabrizio","family":"Brindisino","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cVincenzo Tiberio\u201d, University of Molise c\/o Cardarelli Hospital, C\/da Tappino, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Barassi","sequence":"additional","affiliation":[{"name":"Antalgic Mini-invasive and Rehab-Outpatients Unit, Department of Medicine and Science of Aging, University \u201cG. d\u2019Annunzio\u201d Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5266-6862","authenticated-orcid":false,"given":"Alessandro","family":"Specchia","sequence":"additional","affiliation":[{"name":"Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, 23845 Lecco, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2899-146X","authenticated-orcid":false,"given":"Angelo","family":"Di Iorio","sequence":"additional","affiliation":[{"name":"Antalgic Mini-invasive and Rehab-Outpatients Unit, Department of Medicine and Science of Aging, University \u201cG. d\u2019Annunzio\u201d Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaello","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Antalgic Mini-invasive and Rehab-Outpatients Unit, Department of Medicine and Science of Aging, University \u201cG. d\u2019Annunzio\u201d Chieti-Pescara, 66100 Chieti, Italy"},{"name":"Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano\u2013Pazzallo, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.2340\/16501977-0509","article-title":"Time-course and determinants of spasticity during the first six months following first-ever stroke","volume":"42","author":"Smits","year":"2010","journal-title":"J. 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