{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:00:32Z","timestamp":1792180832299,"version":"4.4.0"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ipsen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>We conducted a multicenter and retrospective study to describe the use of botulinum toxin type A (BoNT-A) to treat post-stroke spasticity (PSS). Data were extracted from free-text in electronic health records (EHRs) in five Spanish hospitals. We included adults diagnosed with PSS between January 2015 and December 2019, stratified into BoNT-A-treated and untreated groups. We used EHRead\u00ae technology, which incorporates natural language processing and machine learning, as well as SNOMED CT terminology. We analyzed demographic data, stroke characteristics, BoNT-A use patterns, and other treatments. We reviewed the EHRs of 1,233,929 patients and identified 2190 people with PSS with a median age of 69 years; in total, 52.1% were men, 70.7% had cardiovascular risk factors, and 63.2% had suffered an ischemic stroke. Among the PSS patients, 25.5% received BoNT-A at least once. The median time from stroke to spasticity onset was 205 days, and the time from stroke to the first BoNT-A injection was 364 days. The primary goal of BoNT-A treatment was pain control. Among the study cohort, rehabilitation was the most common non-pharmacological treatment (95.5%). Only 3.3% had recorded monitoring scales. In conclusion, a quarter of patients with PSS received BoNT-A mainly for pain relief, typically one year after the stroke. Early treatment, disease monitoring, and better data documentation in EHRs are crucial to improve PSS patients\u2019 care.<\/jats:p>","DOI":"10.3390\/toxins16080340","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T09:34:17Z","timestamp":1722591257000},"page":"340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing and Machine Learning"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-3142","authenticated-orcid":false,"given":"Mar\u00eda Jes\u00fas","family":"Ant\u00f3n","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Rio Hortega University Hospital, 47007 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1104-7264","authenticated-orcid":false,"given":"Montserrat","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital of Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Gabriel","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Son Espases University Hospital, 07210 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Pina","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noem\u00ed","family":"Tapiador","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital Puerta de Hierro-Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5318-223X","authenticated-orcid":false,"given":"Beatriz","family":"De La Calle","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Rio Hortega University Hospital, 47007 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital of Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7063-3687","authenticated-orcid":false,"given":"Paula","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital Puerta de Hierro-Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Bel\u00e9n","family":"Ruspaggiari","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Son Espases University Hospital, 07210 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Consuelo","family":"Tudela","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Conejo","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital of Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Leno","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Son Espases University Hospital, 07210 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Marhuenda","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital Puerta de Hierro-Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Arias-Cabrales","sequence":"additional","affiliation":[{"name":"Savana Research S.L, 28004 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3469-7261","authenticated-orcid":false,"given":"Pascal","family":"Maisonobe","sequence":"additional","affiliation":[{"name":"Department of Biometry, Ipsen Pharma, 92100 Boulogne-Billancourt, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Herrera","sequence":"additional","affiliation":[{"name":"Medical Affairs, Ipsen Pharma, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Candau","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Rio Hortega University Hospital, 47007 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1212\/WNL.0000000000012781","article-title":"Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kuriakose, D., and Xiao, Z. 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