Toxin injections prove useful for spasticity after stroke

INDIANAPOLIS Researchers are offering new hope for stroke patients suffering from spasticity of the hand with a drug that has proven effective in relieving muscle tightness or twitching in other areas of the body, according to an article in the Aug. 8 issue of the New England Journal of Medicine. The report indicates that botulinum toxin type A, also known as Botox, reduces disability caused by spasticity of the wrist and finger muscles in patients who have had a stroke. This is the first placebo-controlled, multi-center trial to assess the benefit of one-time injections of botulinum toxin type A.

Allison Brashear, M.D., principal investigator and first author of the article, said the results demonstrate a useful treatment for patients with functional disabilities from stroke.

"This is the first large trial to show that botulinum toxin type A improved function and muscle tone following a stroke," said Dr. Brashear, associate professor of neurology at the Indiana University School of Medicine. "A number of studies have demonstrated that botulinum toxin type A decreases muscle rigidity in spastic muscles and one small study has shown functional improvement from this therapy. However, use of the therapy has become common practice so the point of this clinical trial was to assess the effects of one-time treatment on a large, controlled group."

Stroke affects approximately 600 out of every 100,000 people in the United States, with nearly 70 percent of patients surviving the stroke. The prevalence of disabilities associated with stroke, including arm and hand spasticity, is high. Spasticity in upper limbs is especially debilitating because it can interfere with many daily activities, including personal hygiene and dressing.

Nineteen medical institutions were involved over the two-year period of the study. All of the 126 volunteers enrolled in the 12-week study had some degree of spasticity in their wrist or fingers after a stroke. The v

Contact: Mary Hardin
Indiana University

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