Abstract
The main objective was to assess the efficacy of botulinum toxin-based treatment for sialorrhea in adult patients with Parkinson’s disease. The search was performed by using the Medline-PubMed, EMBASE and Cochrane Library databases from January 2000–December 2017, in English/Spanish in patients with Parkinson’s disease and sialorrhea. The methodological quality of trials was carried out by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria and the Newcastle–Ottawa Scale (NOS). Finally, a total of 21 articles were identified as fulfilling the inclusion criteria. There is no consensus regarding the site of injection of the toxin (single or multiple points), toxin dose or follow-up period. In all cases there was a reduction of sialorrhea. Treatment safety increases with the use of ultrasonography. Effects approximately occur at one week post-injection and for 3–5 months. Botulinum toxin is an effective therapeutic strategy or option in treating sialorrhea in adult patients with Parkinson’s disease. More studies with a better design, larger samples and a longer follow-up period are required to confirm these data.
Highlights
Parkinson’s disease is a chronic and progressive neurodegenerative condition with such an incidence [1] that, as the condition progresses, patients experience a deterioration of motor and non-motor symptoms [2]
BTXB represents a safe and efficacious tool for the management of PD related drooling, ensuring a long-lasting waning of this disabling symptom
BNT-A injections according to the current protocol can effectively manage sialorrhea while maintaining oral health
Summary
Parkinson’s disease is a chronic and progressive neurodegenerative condition with such an incidence [1] that, as the condition progresses, patients experience a deterioration of motor and non-motor symptoms [2]. The prevalence of sialorrhea in PD patients ranges from 10% to 86% [3,4,5,6,7]. The treatment of sialorrhea in these patients aims at reducing drooling with a good risk-benefit ratio [9,10,11,12]. Treatments such as myofascial therapy and anticholinergic drugs—which inhibit the production of saliva—have a wide variety of side effects. Invasive treatments such as surgery or radiotherapy are currently being offered for controlling sialorrhea [4,5,8,9]
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