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Toxins 2015, 7(9), 3818-3844; doi:10.3390/toxins7093818

Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders

1
National Research Council (CNR) of Italy, Institute of Cell Biology and Neurobiology, Roma 00185, Italy
2
Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg East 9220, Denmark
3
Former Professor of Child & Adolescent Neuropsychiatry, University of Cagliari, Cagliari 09124, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Bahman Jabbari
Received: 14 July 2015 / Accepted: 15 September 2015 / Published: 23 September 2015
(This article belongs to the Collection Botulinum Toxins on Human Pain)
View Full-Text   |   Download PDF [333 KB, uploaded 25 September 2015]

Abstract

Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a “glamour” drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A. View Full-Text
Keywords: botulinum toxin; headache; migraine; tension-type headache; cluster headache; cephalalgias; animal pain model; human pain model; clinical trials botulinum toxin; headache; migraine; tension-type headache; cluster headache; cephalalgias; animal pain model; human pain model; clinical trials
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Luvisetto, S.; Gazerani, P.; Cianchetti, C.; Pavone, F. Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders. Toxins 2015, 7, 3818-3844.

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