Category: Dystonia: Clinical Trials and Therapy
Objective: To assess botulinum toxin outcomes in patients with lower limb dystonia.
Background: One of the most effective treatments for dystonia is botulinum toxin (BoNT) injection to affected muscle groups. However, the literature supporting BoNT for leg dystonia is quite limited, which unfortunately impacts insurance coverage for some patients. The primary goal of this study was to evaluate BoNT outcomes in patients with lower limb dystonia.
Method: Patients with lower limb dystonia (N=17) who regularly receive BoNT were enrolled. Outcome measures were assessed at two time points: baseline measures are obtained during their routine BoNT clinic visit (T0) and patients returned 3-8 weeks later during their peak-dose benefit (T1). At both T0 and T1, patients completed the Clinical Global Impression Scales for the following outcome measures: gait, mobility, range of motion, pain, abnormal positions, independence, sleep, concentration, and falls. A video-taped neurologic exam was conducted at both time points and leg dystonia was scored by blinded raters according to the Unified Dystonia Rating Scale (UDRS) and the Fahn-Marsden Dystonia Rating Scale (FMDRS). T-test was used for statistical analysis.
Results: Demographically, 65% were female, the average age was 66, and the most common underlying cause of the leg dystonia was Parkinson’s disease (N=13) followed by DYT-1 (N=2) or idiopathic causes (N=2). Compared to baseline, patients rated a significant improvement in the severity of the following symptoms: range of motion (T0: 4.12, T1: 2.33, p=0.011), pain (T0: 3.41, T1: 1.78, p=0.036), abnormal position (T0:4.24, T1: 2.89, p=0.045), sleep (T0:2.94, T1:1.44, p=0.009), and concentration (T0:2.61, T1:1.67, p=0.03). There was non-statistically significant improvement in gait (T0:4.12, T1: 3.13, p=0.132), mobility (T0:3.94, T1:3.0, p=0.085), independence (T0:3.41, T1:2.78, p=0.489), and mood (T0:2.59, T1:1.67, p=0.124). There was also a non-significant improvement in dystonia in the leg portions on the UDRS (T0:5.9, T1:4.9, p=0.489) and FMDRS (T0:9.7, T1:8.9, p=0.506).
Conclusion: These preliminary results demonstrate that BoNT for lower limb dystonia leads to significant improvement in many symptoms experienced by patients, and there is also objective improvement in lower limb dystonia scores during peak dose benefit. We expect to enroll an additional 40 patients to further assess these measures.
To cite this abstract in AMA style:
M. Wajid, J. Frey, L. Kugler, T. Stiep, J. Yu, J. Toledo, J. Lopes, A. Ramirez-Zamora, A. Rawls, A. Wagle Shukla, I. Malaty. Botulinum Toxin Outcomes in Patients with Lower Limb Dystonia [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/botulinum-toxin-outcomes-in-patients-with-lower-limb-dystonia/. Accessed June 14, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/botulinum-toxin-outcomes-in-patients-with-lower-limb-dystonia/