Factors influencing botulinum toxin response in cervical dystonia: a two-center GAS-based study.
Abstract
[BACKGROUND] Botulinum toxin (BoNT) is first-line therapy for cervical dystonia (CD), yet treatment response is heterogeneous. Patient-centered outcomes may be better captured by Goal Attainment Scaling (GAS) than by examiner-rated motor scales. We aimed to identify clinical factors influencing BoNT response in CD using GAS.
[METHODS] We conducted a retrospective two-center study including adults with CD treated with BoNT between January 2011 and August 2025. Treatment response was assessed using GAS T-scores. The primary outcome was achieving GAS ≥ 50 after the first session; the secondary outcome was achieving GAS > 50 in at least one session during follow-up.
[RESULTS] Eighty-seven patients were included (74.7% female; median age 68 years; median follow-up 4 years). Patients with focal cervical dystonia were significantly more likely to achieve a GAS score ≥ 50 after the first treatment session than those with non-focal forms (segmental, multifocal, or generalized dystonia; OR 5.667; 95% CI 1.853-17.326; p = 0.001). Failure to achieve a GAS score > 50 was significantly associated with the presence of other neurological disorders (OR 0.284; p = 0.020) or concomitant movement disorders (OR 0.211; p = 0.010). Ultrasound guidance was not associated with higher GAS scores.
[CONCLUSION] Focal dystonia and absence of neurological comorbidities were associated with better BoNT response. Ultrasound guidance did not confer measurable benefit in this real-world cohort. GAS may support individualized treatment evaluation in CD.
[METHODS] We conducted a retrospective two-center study including adults with CD treated with BoNT between January 2011 and August 2025. Treatment response was assessed using GAS T-scores. The primary outcome was achieving GAS ≥ 50 after the first session; the secondary outcome was achieving GAS > 50 in at least one session during follow-up.
[RESULTS] Eighty-seven patients were included (74.7% female; median age 68 years; median follow-up 4 years). Patients with focal cervical dystonia were significantly more likely to achieve a GAS score ≥ 50 after the first treatment session than those with non-focal forms (segmental, multifocal, or generalized dystonia; OR 5.667; 95% CI 1.853-17.326; p = 0.001). Failure to achieve a GAS score > 50 was significantly associated with the presence of other neurological disorders (OR 0.284; p = 0.020) or concomitant movement disorders (OR 0.211; p = 0.010). Ultrasound guidance was not associated with higher GAS scores.
[CONCLUSION] Focal dystonia and absence of neurological comorbidities were associated with better BoNT response. Ultrasound guidance did not confer measurable benefit in this real-world cohort. GAS may support individualized treatment evaluation in CD.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 2 | |
| 해부 | cervical
|
scispacy | 1 | ||
| 약물 | [BACKGROUND] Botulinum toxin
|
scispacy | 1 | ||
| 약물 | [RESULTS] Eighty-seven patients
|
scispacy | 1 | ||
| 약물 | CI 1.853-
|
scispacy | 1 | ||
| 약물 | [CONCLUSION] Focal dystonia
|
scispacy | 1 | ||
| 질환 | dystonia
|
C0013421
Dystonia
|
scispacy | 1 | |
| 질환 | neurological disorders
|
C0027765
nervous system disorder
|
scispacy | 1 | |
| 질환 | movement disorders
|
C0026650
Movement Disorders
|
scispacy | 1 | |
| 질환 | GAS
→ Goal Attainment Scaling
|
scispacy | 1 | ||
| 질환 | focal cervical
|
scispacy | 1 | ||
| 기타 | BoNT
→ Botulinum toxin
|
scispacy | 1 | ||
| 기타 | female
|
scispacy | 1 | ||
| 기타 | Patients
|
scispacy | 1 |
MeSH Terms
Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Botulinum Toxins; Neuromuscular Agents; Outcome Assessment, Health Care; Retrospective Studies; Torticollis; Treatment Outcome
📑 인용 관계
이 논문이 참조한 문헌 28
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외부 PMID 18건 (DB 미수집)
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