{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:03:59Z","timestamp":1793916239178,"version":"4.8.0"},"reference-count":13,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medyceles Co. Ltd.","award":["RG\/2567"],"award-info":[{"award-number":["RG\/2567"]}]},{"name":"Chiang Mai University","award":["RG\/2567"],"award-info":[{"award-number":["RG\/2567"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Previous randomized controlled trials (RCTs) investigating Botulinum toxin A (BoNT-A) for treatment of hemifacial spasm (HFS) have primarily focused on symptom relief and quality-of-life improvement. However, head-to-head comparisons of different BoNT-A formulations, particularly in terms of onset, duration of action, and efficacy, remain limited. We conducted a 12-week prospective, randomized controlled trial comparing the efficacy and safety of 33.33 units of Neubotulinum toxin A (Neu-BoNT-A) with 100 units of Abobotulinum toxin A (Abo-BoNT-A) in the treatment of HFS. A total of 87 patients were enrolled between September and December 2024. Neu-BoNT-A and Abo-BoNT-A exhibited similar onset and duration of action [5.0 \u00b1 0.9 vs. 6.2 \u00b1 0.7 days, respectively (p = 0.33)]. After 12 weeks of treatment, Neu-BoNT-A demonstrated superior efficacy in reducing the daily duration of HFS (2.00 \u00b1 0.06 vs. 1.42 \u00b1 0.10 h\/day, p &lt; 0.001) and improving sleep duration (1.37 \u00b1 0.01 vs. 1.06 \u00b1 0.01 h\/day, p &lt; 0.001). However, Abo-BoNT-A was associated with significantly lower absolute daily disability time compared to Neu-BoNT-A (11.4 vs. 1.2 min\/day, p &lt; 0.001). No serious adverse events were observed. Both Neu-BoNT-A and Abo-BoNT-A were safe and effective in treating HFS. However, Neu-BoNT-A was more effective in HFS with minimal symptoms without disability and Abo-BoNT-A more effective in HFS with greater duration of disability.<\/jats:p>","DOI":"10.3390\/toxins17040173","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T04:06:05Z","timestamp":1743566765000},"page":"173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A 12-Week Prospective, Double-Blind, Multicenter, Randomized Study Comparing 100 Units of Abobotulinum Toxin Type A (Dysport\u00ae) and 33.33 Units of Neubotulinum Toxin Type A (Neuronox\u00ae) for the Treatment of Hemifacial Spasm"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-1730","authenticated-orcid":false,"given":"Subsai","family":"Kongsaengdao","sequence":"first","affiliation":[{"name":"Office of Senior Advisor, Department of Medical Services, Ministry of Public Health, Nonthaburi 11000, Thailand"},{"name":"Division of Neurology, Rajavithi Hospital, Department of Medical Services, Ministry of Public Health, Bangkok 10400, Thailand"},{"name":"Division of Neurology, Department of Medicine, College of Medicine, Rangsit University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkhom","family":"Arayawichanont","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanoksri","family":"Samintharapanya","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine Lampang Hospital, Lampang 52000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pichai","family":"Rojanapitayakorn","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine Suratthani Hospital, Suratthani 84000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6125-6489","authenticated-orcid":false,"given":"Benchalak","family":"Maneeton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narong","family":"Maneeton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1007\/s10072-017-3107-2","article-title":"A comparative crossover study on the treatment of hemifacial spasm and blepharospasm: Preseptal and pretarsal botulinum toxin injection techniques","volume":"38","author":"Lolekha","year":"2017","journal-title":"Neurol. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/01.WNF.0000236771.77021.3C","article-title":"A double-blind, randomized, crossover study of prosigne versus botox in patients with blepharospasm and hemifacial spasm","volume":"30","author":"Rieder","year":"2007","journal-title":"Clin. Neuropharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/WNF.0b013e3181c46f61","article-title":"Prospective, randomized, double-blind study, comparing botulinum toxins type a botox and prosigne for blepharospasm and hemifacial spasm treatment","volume":"33","author":"Quagliato","year":"2010","journal-title":"Clin. Neuropharmacol."},{"key":"ref_4","first-page":"S48","article-title":"Quality of life in hemifacial spasm patient after treatment with botulinum toxin A; a 24-week, double-blind, randomized, cross-over comparison of Dysport and Neuronox study","volume":"95","author":"Kongsengdao","year":"2012","journal-title":"J. Med. Thai."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s10072-013-1357-1","article-title":"Conversion ratio between Dysport and Botox in clinical practice: An overview of available evidence","volume":"34","author":"Ravenni","year":"2013","journal-title":"Neurol. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Yi, K.-H., Lee, J.-H., Kim, G.-Y., Yoon, S.-W., Oh, W., and Kim, H.-J. (2022). Novel Anatomical Proposal for Botulinum Neurotoxin Injection Targeting Lateral Canthal Rhytids. Toxins, 14.","DOI":"10.3390\/toxins14070462"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/j.1469-8749.2010.03830.x","article-title":"Neuronox versus BOTOX for spastic equinus gait in children with cerebral palsy: A randomized, double-blinded, controlled multicentre clinical trial","volume":"53","author":"Kim","year":"2011","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1212\/01.wnl.0000311389.26145.95","article-title":"Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology","volume":"70","author":"Simpson","year":"2008","journal-title":"Neurology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tambasco, N., Filidei, M., Nigro, P., Parnetti, L., and Simoni, S. (2021). Botulinum Toxin for the Treatment of Hemifacial Spasm: An Update on Clinical Studies. Toxins, 13.","DOI":"10.3390\/toxins13120881"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1185\/030079905X36396","article-title":"Safety, effectiveness, and duration of effect of BOTOX after switching from Dysport for blepharospasm, cervical dystonia, and hemifacial spasm dystonia, and hemifacial spasm","volume":"21","author":"Bihari","year":"2005","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kongsaengdao, S., Maneeton, N., and Maneeton, B. (2021). The Five-Year Prospective Study of Quality of Life in Hemifacial Spasm Treated with Abo-Botulinum Toxin A. Toxins, 13.","DOI":"10.3390\/toxins13030215"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s10072-019-03921-4","article-title":"Validation of the Hemifacial Spasm Grading Scale: A clinical tool for hemifacial spasm","volume":"40","author":"Tambasco","year":"2019","journal-title":"Neurol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1136\/jnnp.2005.065656","article-title":"Validation of a short disease specific quality of life scale for hemifacial spasm: Correlation with SF-36","volume":"76","author":"Tan","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/4\/173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:08:19Z","timestamp":1760029699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/4\/173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["toxins17040173"],"URL":"https:\/\/doi.org\/10.3390\/toxins17040173","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,2]]}}}