Botulinum toxin for diabetic neuropathic pain: A randomized double-blind crossover trial

Rey-Yue Yuan, Jau-Jiuan Sheu, Jia Ming Yu, Wei Ta Chen, Ing Jy Tseng, Hsiu Hui Chang, Chaur-Jong Hu

研究成果: 雜誌貢獻文章

178 引文 (Scopus)

摘要

Background: Diabetic neuropathy is a common complication in diabetes, with patients typically experiencing diverse sensory symptoms including dysesthesias in the feet and usually accompanied by sleep disturbance. There is still no comprehensive understanding of the underlying biologic processes responsible for diabetic neuropathic pain. Thus, the current symptomatic therapy remains unsatisfactory. Recent experimental evidence suggests that botulinum toxin type A (BoNT/A) may not only inhibit the release of acetylcholine at the neuromuscular junctions, but also modulate afferent sensory fiber firing, thereby relieving neuropathic pain. Methods: A double-blind crossover trial of intradermal BoNT/A for diabetic neuropathic pain in 18 patients was conducted to evaluate the effectiveness. Results: We find significant reduction in visual analog scale (VAS) of pain by 0.83 ± 1.11 at 1 week, 2.22 ± 2.24 at 4 weeks, 2.33 ± 2.56 at 8 weeks, and 2.53 ± 2.48 at 12 weeks after injection in the BoNT/A group, as compared to the respective findings for a placebo group of 0.39 ± 1.18, -0.11 ± 2.04, 0.42 ± 1.62, and 0.53 ± 1.57 at the same timepoints (p < 0.05). Within the BoNT/A group, 44.4% of the participants experienced a reduction of VAS ≥3 within 3 months after injection, whereas there was no similar response in the placebo group. At the 4-week postinjection stage, improvement in sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. Conclusions: This pilot study found that botulinum toxin type A significantly reduced diabetic neuropathic pain and transiently improved sleep quality. Further large-scaled study is warranted.
原文英語
頁(從 - 到)1473-1478
頁數6
期刊Neurology
72
發行號17
DOIs
出版狀態已發佈 - 四月 28 2009

指紋

Type A Botulinum Toxins
Botulinum Toxins
Neuralgia
Cross-Over Studies
Sleep
Placebos
Injections
Diabetic Neuropathies
Paresthesia
Neuromuscular Junction
Pain Measurement
Diabetes Complications
Visual Analog Scale
Double-Blind Method
Acetylcholine
Foot

ASJC Scopus subject areas

  • Clinical Neurology

引用此文

Botulinum toxin for diabetic neuropathic pain : A randomized double-blind crossover trial. / Yuan, Rey-Yue; Sheu, Jau-Jiuan; Yu, Jia Ming; Chen, Wei Ta; Tseng, Ing Jy; Chang, Hsiu Hui; Hu, Chaur-Jong.

於: Neurology, 卷 72, 編號 17, 28.04.2009, p. 1473-1478.

研究成果: 雜誌貢獻文章

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abstract = "Background: Diabetic neuropathy is a common complication in diabetes, with patients typically experiencing diverse sensory symptoms including dysesthesias in the feet and usually accompanied by sleep disturbance. There is still no comprehensive understanding of the underlying biologic processes responsible for diabetic neuropathic pain. Thus, the current symptomatic therapy remains unsatisfactory. Recent experimental evidence suggests that botulinum toxin type A (BoNT/A) may not only inhibit the release of acetylcholine at the neuromuscular junctions, but also modulate afferent sensory fiber firing, thereby relieving neuropathic pain. Methods: A double-blind crossover trial of intradermal BoNT/A for diabetic neuropathic pain in 18 patients was conducted to evaluate the effectiveness. Results: We find significant reduction in visual analog scale (VAS) of pain by 0.83 ± 1.11 at 1 week, 2.22 ± 2.24 at 4 weeks, 2.33 ± 2.56 at 8 weeks, and 2.53 ± 2.48 at 12 weeks after injection in the BoNT/A group, as compared to the respective findings for a placebo group of 0.39 ± 1.18, -0.11 ± 2.04, 0.42 ± 1.62, and 0.53 ± 1.57 at the same timepoints (p <0.05). Within the BoNT/A group, 44.4{\%} of the participants experienced a reduction of VAS ≥3 within 3 months after injection, whereas there was no similar response in the placebo group. At the 4-week postinjection stage, improvement in sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. Conclusions: This pilot study found that botulinum toxin type A significantly reduced diabetic neuropathic pain and transiently improved sleep quality. Further large-scaled study is warranted.",
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AU - Yuan, Rey-Yue

AU - Sheu, Jau-Jiuan

AU - Yu, Jia Ming

AU - Chen, Wei Ta

AU - Tseng, Ing Jy

AU - Chang, Hsiu Hui

AU - Hu, Chaur-Jong

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N2 - Background: Diabetic neuropathy is a common complication in diabetes, with patients typically experiencing diverse sensory symptoms including dysesthesias in the feet and usually accompanied by sleep disturbance. There is still no comprehensive understanding of the underlying biologic processes responsible for diabetic neuropathic pain. Thus, the current symptomatic therapy remains unsatisfactory. Recent experimental evidence suggests that botulinum toxin type A (BoNT/A) may not only inhibit the release of acetylcholine at the neuromuscular junctions, but also modulate afferent sensory fiber firing, thereby relieving neuropathic pain. Methods: A double-blind crossover trial of intradermal BoNT/A for diabetic neuropathic pain in 18 patients was conducted to evaluate the effectiveness. Results: We find significant reduction in visual analog scale (VAS) of pain by 0.83 ± 1.11 at 1 week, 2.22 ± 2.24 at 4 weeks, 2.33 ± 2.56 at 8 weeks, and 2.53 ± 2.48 at 12 weeks after injection in the BoNT/A group, as compared to the respective findings for a placebo group of 0.39 ± 1.18, -0.11 ± 2.04, 0.42 ± 1.62, and 0.53 ± 1.57 at the same timepoints (p <0.05). Within the BoNT/A group, 44.4% of the participants experienced a reduction of VAS ≥3 within 3 months after injection, whereas there was no similar response in the placebo group. At the 4-week postinjection stage, improvement in sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. Conclusions: This pilot study found that botulinum toxin type A significantly reduced diabetic neuropathic pain and transiently improved sleep quality. Further large-scaled study is warranted.

AB - Background: Diabetic neuropathy is a common complication in diabetes, with patients typically experiencing diverse sensory symptoms including dysesthesias in the feet and usually accompanied by sleep disturbance. There is still no comprehensive understanding of the underlying biologic processes responsible for diabetic neuropathic pain. Thus, the current symptomatic therapy remains unsatisfactory. Recent experimental evidence suggests that botulinum toxin type A (BoNT/A) may not only inhibit the release of acetylcholine at the neuromuscular junctions, but also modulate afferent sensory fiber firing, thereby relieving neuropathic pain. Methods: A double-blind crossover trial of intradermal BoNT/A for diabetic neuropathic pain in 18 patients was conducted to evaluate the effectiveness. Results: We find significant reduction in visual analog scale (VAS) of pain by 0.83 ± 1.11 at 1 week, 2.22 ± 2.24 at 4 weeks, 2.33 ± 2.56 at 8 weeks, and 2.53 ± 2.48 at 12 weeks after injection in the BoNT/A group, as compared to the respective findings for a placebo group of 0.39 ± 1.18, -0.11 ± 2.04, 0.42 ± 1.62, and 0.53 ± 1.57 at the same timepoints (p <0.05). Within the BoNT/A group, 44.4% of the participants experienced a reduction of VAS ≥3 within 3 months after injection, whereas there was no similar response in the placebo group. At the 4-week postinjection stage, improvement in sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. Conclusions: This pilot study found that botulinum toxin type A significantly reduced diabetic neuropathic pain and transiently improved sleep quality. Further large-scaled study is warranted.

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