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OnabotulinumtoxinA Improves Tactile and Mechanical Pain Perception in Painful Diabetic Polyneuropathy.
MedLine Citation:
PMID:  23462284     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: Diabetic neuropathic pain may be relieved by onabotulinumtoxinA (BoNT/A). However, whether BoNT/A changes sensory perception in neuropathic patients remains unknown. This study used a double-blind crossover design to explore the possible effect of BoNT/A on sensory perception. METHODS:: Eighteen patients with painful diabetic polyneuropathy underwent 2 consecutive 12-week periods of treatment either in the sequence of saline (control) and then BoNT/A (SB cohort, n=9) or BoNT/A followed by saline (BS cohort, n=9). Sensory perception was assessed according to the tactile threshold [TT, logarithmized force (g) of von Frey filaments] and mechanical pain threshold [PT, logarithmized weight (g) of weighted syringes], both being averages from 4 individual measurements of bilateral medial and lateral feet obtained at baseline (before injections) and at weeks 1, 4, 8, and 12 after treatment. RESULTS:: In either the SB or the BS cohort, there was a decrease in the TT and the PT after treatment with BoNT/A but not with saline. In the analysis merging both cohorts (n=18), BoNT/A resulted in a significant decrease in TT and PT at weeks 1, 4, 8, and 12 (all Ps<0.05 vs. saline). The longitudinal effect of BoNT/A on TT and PT remained significant when baseline values, treatment sequences, and periods were controlled using generalized estimating equations. DISCUSSION:: BoNT/A may improve tactile and mechanical pain perception in painful diabetic polyneuropathy. The beneficial effects of BoNT/A deserves further study to elucidate the exact mechanism and potential for preventing insensate injuries.
Authors:
Wei-Ta Chen; Rey-Yue Yuan; Shu-Chiung Chiang; Jau-Jiuan Sheu; Jia-Ming Yu; Ing-Jy Tseng; Szu-Kuan Yang; Hsiu-Hui Chang; Chaur-Jong Hu
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  The Clinical journal of pain     Volume:  29     ISSN:  1536-5409     ISO Abbreviation:  Clin J Pain     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-3-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507389     Medline TA:  Clin J Pain     Country:  -    
Other Details:
Languages:  ENG     Pagination:  305-310     Citation Subset:  -    
Affiliation:
*The Neurologic Institute ∥Information Management Offices, Taipei Veterans General Hospital †School of Medicine, National Yang-Ming University ‡Department of Neurology ¶College of Nursing, Taipei Medical University and Hospital, Taipei **Department of International Trade, Chungyu Institute of Technology, Keelung, Taiwan #Department of Neurology, Chang Bing Show-Chwan Memorial Hospital, Changhua, Taiwan; ††Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan §Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA.
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