Abstract
Botulinum toxin type A (BoNT/A) provides a valuable tool in the multi-modal treatment of spasticity. Incobotulinumtoxin A (InBoNT/A) is a highly purified BoNT/A agent, free of any complexing clostridial proteins.Clinical experience suggests that InBoNT/A is identical from efficacy, duration of therapeutic effect and tolerability profile. Our aim was to compare the effect of the CBoNT/A vs InBoNT/A on spasticity of the upper limb, evaluated with Modificated Aswhort Scale (MAS), and on amplitude of compound motor action potentials (CMAP) of biceps muscle in patients after brain stroke. A randomized, double-blind, parallel-group pilot single-centre study. Clinical and neurophysiological evaluation were performed at enrollment (T0), to 24 h (T1),one (T2) and three (T3) months from toxin injection. We recruited 9 subject. Both BoNTA reduced MAS scores but with no statistically significant difference. At T1 patients treated with IBoNT/A showed a greater reduction in CMAP compared with those treated with CBoNT/A. This difference is reduced at T2 but is again evident at T3. These data seem to indicate a tendency of IBoNT/A to present a more precocious and a longer duration effect respect to CBoNT/A. The low power of the statistical analysis, however, suggests to recruit a larger sample of patients.
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