{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:20:44Z","timestamp":1788344444859,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ipsen Pharma GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Cervical dystonia (CD) is a hyperkinetic movement disorder characterized by involuntary muscle contractions leading to abnormal postures of the head and neck. The injection of botulinum neurotoxin type A (BoNT-A) into the muscles involved is the treatment of choice for CD. BoNT-A therapy of CD requires appropriate training, which has not been standardized in Germany. To address the key challenges in BoNT-A education, an expert panel developed a simplified step-by-step treatment guideline for beginners, adapted from the established Col-Cap-Concept (\u201cDystonia 3\u00d73\u201d). Based on expert consensus, recommendations were developed for the core clinical elements of BoNT-A treatment in CD\u2014recognition of the movement pattern, identification of target muscles, development of an injection plan, ultrasound-guided injection, and dosing, taking into account the target audience of the guideline. As such, Dystonia 3\u00d73 provides a user-friendly beginner\u2019s guidebook, enhancing accessibility and standardization of CD treatment training. Further research is required to evaluate its clinical efficacy and suitability for training.<\/jats:p>","DOI":"10.3390\/toxins18090378","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:02:52Z","timestamp":1788343372000},"page":"378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dystonia 3\u00d73: A Training Guideline for Beginners in Botulinum Neurotoxin Treatment of Cervical Dystonia"],"prefix":"10.3390","volume":"18","author":[{"given":"Sebastian","family":"Paus","sequence":"first","affiliation":[{"name":"Department of Neurology, GFO Kliniken Troisdorf, 53844 Troisdorf, Germany"},{"name":"Center for Neurology, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2606-2563","authenticated-orcid":false,"given":"Andreas","family":"Funke","sequence":"additional","affiliation":[{"name":"Neurologie am Funkerberg, 15711 K\u00f6nigs Wusterhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Hamacher","sequence":"additional","affiliation":[{"name":"Praxis NeuroMotion, 45219 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Haslinger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University Munich, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0597-3269","authenticated-orcid":false,"given":"Jan","family":"Heckelmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, RWTH University Hospital Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Wang","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8574-3297","authenticated-orcid":false,"given":"Wolfgang H.","family":"Jost","sequence":"additional","affiliation":[{"name":"Parkinson-Klinik Ortenau, 77709 Wolfach, Germany"},{"name":"Department of Neurology, Saarland University, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2959-2378","authenticated-orcid":false,"given":"Anatol","family":"Kivi","sequence":"additional","affiliation":[{"name":"Department of Neurological Rehabilitation and Physical Therapy, Vivantes Klinikum Spandau, 13585 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Klebe","sequence":"additional","affiliation":[{"name":"Department of Neurology, Knappschaft Kliniken Recklinghausen, 45657 Recklinghausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John-Ih","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology, GFO Kliniken Rhein-Berg, 51465 Bergisch Gladbach, Germany"},{"name":"Department of Neurology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich Heine University D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebba","family":"Lohmann","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen (DZNE), University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Neurology, GFO Kliniken Troisdorf, 53844 Troisdorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Schramm","sequence":"additional","affiliation":[{"name":"NeuroPraxis Fuerth, 90762 Fuerth, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Stenner","sequence":"additional","affiliation":[{"name":"Movement Disorders Competence Center, Medizinisches Versorgungszentrum Zwickau, 08060 Zwickau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Tacik","sequence":"additional","affiliation":[{"name":"Center for Neurology, Department of Parkinson\u2019s Disease, Sleep and Movement Disorders, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-785X","authenticated-orcid":false,"given":"Uwe","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rostock University Medical Center, 18147 Rostock, Germany"},{"name":"Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen (DZNE) Rostock\/Greifswald, 18147 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5772-6609","authenticated-orcid":false,"given":"David T.","family":"Weise","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asklepios Fachklinikum Stadtroda, 07646 Stadtroda, Germany"},{"name":"Department of Neurology, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1002\/mds.29387","article-title":"Isolated Cervical Dystonia: Diagnosis and Classification","volume":"38","author":"Albanese","year":"2023","journal-title":"Mov. 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