Next Article in Journal
Accumulation and Biotransformation of Dinophysis Toxins by the Surf Clam Mesodesma donacium
Next Article in Special Issue
The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients
Previous Article in Journal
Effects of Feeding a Mycotoxin Binder on Nutrient Digestibility, Alkaloid Recovery in Feces, and Performance of Lambs Fed Diets Contaminated with Cereal Ergot
Previous Article in Special Issue
Incobotulinumtoxin A for Sialorrhea in Neurological Disorders: A Real-Life Experience
Article Menu
Issue 8 (August) cover image

Export Article

Open AccessReview
Toxins 2018, 10(8), 313;

Botulinum Toxin Induced Atrophy: An Uncharted Territory

Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, 339 Windermere Road, A10-026, London, ON N6A 5A5, Canada
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]


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).

Supplementary material


Share & Cite This Article

MDPI and ACS Style

Salari, M.; Sharma, S.; Jog, M.S. Botulinum Toxin Induced Atrophy: An Uncharted Territory. Toxins 2018, 10, 313.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Toxins EISSN 2072-6651 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top