Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy
Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth...
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MDPI AG
2022-02-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/14/2/139 |
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| author | Nathalie De Beukelaer Guido Weide Ester Huyghe Ines Vandekerckhove Britta Hanssen Nicky Peeters Julie Uytterhoeven Jorieke Deschrevel Karen Maes Marlies Corvelyn Domiziana Costamagna Ghislaine Gayan-Ramirez Anja Van Campenhout Kaat Desloovere |
| author_facet | Nathalie De Beukelaer Guido Weide Ester Huyghe Ines Vandekerckhove Britta Hanssen Nicky Peeters Julie Uytterhoeven Jorieke Deschrevel Karen Maes Marlies Corvelyn Domiziana Costamagna Ghislaine Gayan-Ramirez Anja Van Campenhout Kaat Desloovere |
| author_sort | Nathalie De Beukelaer |
| collection | DOAJ |
| description | Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (<i>n</i> = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (<i>n</i> = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (<i>n</i> = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (<i>n</i> = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, <i>p</i> < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis. |
| first_indexed | 2024-03-09T20:55:37Z |
| format | Article |
| id | doaj.art-94daf23f02604cc4bc01557a8b5c03e7 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-09T20:55:37Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-94daf23f02604cc4bc01557a8b5c03e72023-11-23T22:22:00ZengMDPI AGToxins2072-66512022-02-0114213910.3390/toxins14020139Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral PalsyNathalie De Beukelaer0Guido Weide1Ester Huyghe2Ines Vandekerckhove3Britta Hanssen4Nicky Peeters5Julie Uytterhoeven6Jorieke Deschrevel7Karen Maes8Marlies Corvelyn9Domiziana Costamagna10Ghislaine Gayan-Ramirez11Anja Van Campenhout12Kaat Desloovere13Neurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumLaboratory of Respiratory Diseases and Thoracic Surgery, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, BelgiumLaboratory of Respiratory Diseases and Thoracic Surgery, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, BelgiumStem Cell Biology and Embryology, Department of Development and Regeneration, KU Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumLaboratory of Respiratory Diseases and Thoracic Surgery, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, BelgiumUnit of Pediatric Orthopedics, Department of Orthopedics, University Hospitals Leuven, 3000 Leuven, BelgiumNeurorehabilitation Group, Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, BelgiumBotulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (<i>n</i> = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (<i>n</i> = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (<i>n</i> = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (<i>n</i> = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, <i>p</i> < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.https://www.mdpi.com/2072-6651/14/2/139botulinum neurotoxin type-Aspastic cerebral palsymuscle growth rate3D freehand ultrasound |
| spellingShingle | Nathalie De Beukelaer Guido Weide Ester Huyghe Ines Vandekerckhove Britta Hanssen Nicky Peeters Julie Uytterhoeven Jorieke Deschrevel Karen Maes Marlies Corvelyn Domiziana Costamagna Ghislaine Gayan-Ramirez Anja Van Campenhout Kaat Desloovere Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy Toxins botulinum neurotoxin type-A spastic cerebral palsy muscle growth rate 3D freehand ultrasound |
| title | Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy |
| title_full | Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy |
| title_fullStr | Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy |
| title_full_unstemmed | Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy |
| title_short | Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy |
| title_sort | reduced cross sectional muscle growth six months after botulinum toxin type a injection in children with spastic cerebral palsy |
| topic | botulinum neurotoxin type-A spastic cerebral palsy muscle growth rate 3D freehand ultrasound |
| url | https://www.mdpi.com/2072-6651/14/2/139 |
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