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Plastic and Reconstructive Surgery.... Jun 2014Magnetic resonance imaging (MRI) has not yet been established systematically to detect structural muscular changes after facial nerve lesion. The purpose of this pilot...
BACKGROUND
Magnetic resonance imaging (MRI) has not yet been established systematically to detect structural muscular changes after facial nerve lesion. The purpose of this pilot study was to investigate quantitative assessment of MRI muscle volume data for facial muscles.
METHODS
Ten healthy subjects and 5 patients with facial palsy were recruited. Using manual or semiautomatic segmentation of 3T MRI, volume measurements were performed for the frontal, procerus, risorius, corrugator supercilii, orbicularis oculi, nasalis, zygomaticus major, zygomaticus minor, levator labii superioris, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis, as well as for the masseter and temporalis as masticatory muscles for control.
RESULTS
All muscles except the frontal (identification in 4/10 volunteers), procerus (4/10), risorius (6/10), and zygomaticus minor (8/10) were identified in all volunteers. Sex or age effects were not seen (all P > 0.05). There was no facial asymmetry with exception of the zygomaticus major (larger on the left side; P = 0.012). The exploratory examination of 5 patients revealed considerably smaller muscle volumes on the palsy side 2 months after facial injury. One patient with chronic palsy showed substantial muscle volume decrease, which also occurred in another patient with incomplete chronic palsy restricted to the involved facial area. Facial nerve reconstruction led to mixed results of decreased but also increased muscle volumes on the palsy side compared with the healthy side.
CONCLUSIONS
First systematic quantitative MRI volume measures of 5 different clinical presentations of facial paralysis are provided.
PubMed: 25289366
DOI: 10.1097/GOX.0000000000000128 -
Internal Medicine (Tokyo, Japan) 2007To evaluate the efficacy and tolerability of Botulinum Toxin Type A (BoNT-A) for migraine prophylaxis. (Clinical Trial)
Clinical Trial
OBJECTIVE
To evaluate the efficacy and tolerability of Botulinum Toxin Type A (BoNT-A) for migraine prophylaxis.
METHODS
Nineteen Japanese adult patients (50 +/- 10 years old), who met the International Classification of Headache Disorders 2nd Edition (ICHD II) criteria for migraine and had five or more migraine attacks a month, were enrolled in this open-label prospective study. A total of 50 units of BoNT-A were injected in 19-fixed sites of the muscles including procerus, corrugator, frontalis, temporalis and occipitalis. All participants were advised to stop taking preventive medicine from one month before and three months after BoNT-A injection. Migraine disability assessment (MIDAS), migraine questionnaire and headache diary were used for the evaluation of efficacy. Seven patients received repeated injection combined with prophylactic medication.
RESULT
We excluded five patients from the analysis because four patients had medication overuse headache and one continued preventive medicine. Mean MIDAS score decreased significantly two months after the injection. Thirteen of 14 patients stated subjective improvement after the injection on the migraine questionnaire. The amount of analgesics consumption or headache frequency did not change after injection, but the frequency of severe migraine attacks decreased significantly. No serious adverse event was reported. Repeated injections also showed significant reduction in MIDAS score three months after the second and third injections.
CONCLUSION
BoNT-A injection was an effective and safe treatment for migraine prophylaxis among the Japanese population. A randomized placebo control trial is necessary to confirm its efficacy.
Topics: Adult; Botulinum Toxins, Type A; Disability Evaluation; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Injections, Intramuscular; Japan; Male; Middle Aged; Migraine Disorders; Neuromuscular Agents; Pain Measurement; Probability; Prospective Studies; Risk Assessment; Severity of Illness Index; Single-Blind Method; Statistics, Nonparametric; Treatment Outcome
PubMed: 17603233
DOI: 10.2169/internalmedicine.46.6416 -
Journal of the American Academy of... Apr 2020DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin type A in clinical development. Phase 2 data have shown it offers a more prolonged duration of... (Randomized Controlled Trial)
Randomized Controlled Trial
DaxibotulinumtoxinA for Injection has a prolonged duration of response in the treatment of glabellar lines: Pooled data from two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2).
BACKGROUND
DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin type A in clinical development. Phase 2 data have shown it offers a more prolonged duration of response than onabotulinumtoxinA.
OBJECTIVE
To further evaluate the efficacy, duration of response, and safety of 40 U DAXI compared with placebo in the treatment of glabellar lines.
METHODS
Two identical, multicenter, randomized, double-blind, placebo-controlled, phase 3 studies were performed (NCT03014622 and NCT03014635 on www.clinicaltrials.gov). Participants with moderate or severe glabellar lines were randomly assigned (2:1) to receive 40 U DAXI or placebo into the corrugator/procerus muscles. Glabellar line severity was assessed by investigators and participants for up to 36 weeks (≥24 weeks).
RESULTS
Among 609 participants enrolled (405 DAXI, 204 placebo), 92% completed. DAXI was significantly more effective than placebo in reducing glabellar line severity and maintained none or mild glabellar line severity for a median of 24.0 weeks. It was also generally well tolerated-treatment-related adverse effects were most commonly headache (6.4% vs 2.0%) and injection site pain (3.7% vs 3.9%).
LIMITATIONS
The study population was predominantly female and white and received only a single treatment.
CONCLUSIONS
DAXI offers a prolonged duration of response for glabellar line reduction and is well tolerated.
Topics: Botulinum Toxins, Type A; Cosmetic Techniques; Facial Muscles; Female; Forehead; Humans; Injections, Intramuscular; Male; Neuromuscular Agents; Patient Satisfaction; Skin Aging; Time Factors
PubMed: 31791824
DOI: 10.1016/j.jaad.2019.06.1313 -
Internal Medicine (Tokyo, Japan) Dec 2002
Topics: Aged; Brain Diseases; Facial Muscles; Facies; Female; Humans; Magnetic Resonance Imaging; Neurologic Examination
PubMed: 12521221
DOI: 10.2169/internalmedicine.41.1217 -
Biology of Mood & Anxiety Disorders 2014It has long been suggested that feedback signals from facial muscles influence emotional experience. The recent surge in use of botulinum toxin (BTX) to induce temporary...
BACKGROUND
It has long been suggested that feedback signals from facial muscles influence emotional experience. The recent surge in use of botulinum toxin (BTX) to induce temporary muscle paralysis offers a unique opportunity to directly test this "facial feedback hypothesis." Previous research shows that the lack of facial muscle feedback due to BTX-induced paralysis influences subjective reports of emotional experience, as well as brain activity associated with the imitation of emotional facial expressions. However, it remains to be seen whether facial muscle paralysis affects brain activity, especially the amygdala, which is known to be responsive to the perception of emotion in others. Further, it is unknown whether these neural changes are permanent or whether they revert to their original state after the effects of BTX have subsided. The present study sought to address these questions by using functional magnetic resonance imaging to measure neural responses to angry and happy facial expressions in the presence or absence of facial paralysis.
RESULTS
Consistent with previous research, amygdala activity was greater in response to angry compared to happy faces before BTX treatment. As predicted, amygdala activity in response to angry faces was attenuated when the corrugator/procerus muscles were paralyzed via BTX injection but then returned to its original state after the effects of BTX subsided. This preliminary study comprises a small sample size and no placebo condition; however, the A-B-A design affords the present sample to serve as its own control.
CONCLUSIONS
The current demonstration that amygdala responses to facial expressions were influenced by facial muscle paralysis offers direct neural support for the facial feedback hypothesis. Specifically, the present findings offer preliminary causal evidence that amygdala activity is sensitive to facial feedback during the perception of the facial expressions of others. More broadly, these data confirm the utility of using BTX to address the effect of facial feedback on neural responses associated with the perception, in addition to the experience or expression of emotion.
PubMed: 25694806
DOI: 10.1186/2045-5380-4-11 -
Journal of the Chinese Medical... Dec 2007Botulinum toxin type A (BoNT-A) for the treatment of patients with various forms of migraine has been studied, but there is a paucity of data regarding the use of BoNT-A...
BACKGROUND
Botulinum toxin type A (BoNT-A) for the treatment of patients with various forms of migraine has been studied, but there is a paucity of data regarding the use of BoNT-A in Asian headache patients. Our study was designed to evaluate the efficacy of BoNT-A in the treatment of transformed migraine (TM) in a population of Taiwanese patients.
METHODS
We retrospectively analyzed 30 patients who underwent BoNT-A treatment for TM from July 2003 to May 2004. Of 30 patients, 14 had palpable muscle tenderness (or tender points) in the pericranial region and 16 did not. All patients received injections into the corrugator, procerus, frontalis, and temporalis muscles (a total of 30 U), while a subset of TM patients with tender points (6 of 14 patients) also received injections to additional muscles based on a follow-the-tenderness approach (mean dose, 45 U).
RESULTS
Twenty-seven of the 30 patients (90%) surveyed reported effective relief of their symptoms with BoNT-A treatment (at least a 50% reduction in the number of headache days or in headache intensity). The greatest reduction in headache days per month and headache intensity was found in TM patients with tender points who received a mean dose of 45 U compared to those who received fixed-site dosing of 30 U.
CONCLUSION
Our results suggest that BoNT-A may be an effective prophylactic treatment for TM in Taiwanese patients. Interestingly, similar efficacy was demonstrated in TM patients with tender points compared to those without tender points when an additional dose of BoNT-A was injected into the tender muscles in the former.
Topics: Adult; Aged; Botulinum Toxins, Type A; Female; Headache Disorders; Humans; Male; Middle Aged; Migraine Disorders; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 18194894
DOI: 10.1016/S1726-4901(08)70056-X