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Toxins 2018, 10(8), 313; https://doi.org/10.3390/toxins10080313

Botulinum Toxin Induced Atrophy: An Uncharted Territory

1,2,†
,
1,†
and
1,*
1
Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, 339 Windermere Road, A10-026, London, ON N6A 5A5, Canada
2
Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, 19839-63113 Tehran, Iran
These authors contributed equally to the study and share first authorship.
*
Author to whom correspondence should be addressed.
Received: 4 July 2018 / Revised: 30 July 2018 / Accepted: 31 July 2018 / Published: 2 August 2018
(This article belongs to the Special Issue Botulinum Toxin Treatment of Movement Disorders)
Full-Text   |   PDF [264 KB, uploaded 2 August 2018]

Abstract

Botulinum neurotoxins (BoNTs) produce local chemo-denervation by cleaving soluble N-ethylmaleimide-sensitive factor activating protein receptor (SNARE) proteins. Botulinum neurotoxins are therapeutically indicated in several neurological disorders and have been in use for three decades. The long-term efficacy, safety, and side effects of BoNTs have been well documented in the literature. However, the development of muscle atrophy following chronic exposure to BoNTs has not received sufficient attention. Muscle atrophy is not only cosmetically distressing, but also has an impact on future injections. An extensive literature search was conducted on atrophy and mechanisms of atrophy. Five hundred and four relevant articles in the English language were reviewed. This review revealed the surprising lack of documentation of atrophy within the literature. In addition, as demonstrated in this review, the mechanisms and the clinical factors that may lead to atrophy have also been poorly studied. However, even with this limited information it is possible to indicate factors that could modify the clinical approach to botulinum toxin injections. This review highlights the need for further study of atrophy following BoNT injections. View Full-Text
Keywords: botulinum toxin; atrophy; SNARE botulinum toxin; atrophy; SNARE
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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Salari, M.; Sharma, S.; Jog, M.S. Botulinum Toxin Induced Atrophy: An Uncharted Territory. Toxins 2018, 10, 313.

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