Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Treatment Outcomes
2.2.1. Visual Analog Scale
2.2.2. Pain Frequency
2.2.3. Pain Scale of the Oromandibular Dystonia Rating Scale (OMDRS)
2.3. Trigeminal Neuralgia (TN)
2.4. Myofascial Temporomandibular Disorders (TMD)
2.5. Oromandibular Dystonia (OMD)
3. Discussion
3.1. Mechanism of BoNT/A on Muscle Relaxation and Pain Relief
3.2. Limitations of This Study
3.3. Effects of BoNT/A on TN
3.4. Effects of BoNT/A on Myofascial TMD
3.5. Effects of BoNT/A on OMD
3.6. Difference of Effects of BoNT/A among the Three Groups
3.7. Adverse Effects of BoNT/A
3.8. Future Study on the Clinical Use of BoNT/A
4. Conclusions
5. Materials and Methods
5.1. Patients
5.1.1. TN
5.1.2. Myofascial TMD
5.1.3. OMD
5.2. Botulinum Toxin Therapy
5.2.1. TN
5.2.2. Myofascial TMD and OMD
5.3. Analysis
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Disease Groups | N | Age (Years) [Mean (SD)] | Sex (Female, Male) [N (%)] | Duration (Years) [Mean (SD)] | Visual Analog Scale at Baseline [Mean (SD)] | Pain Frequency at Baseline (Times/Day) [Mean (SD)] | Pain Scale of Oromandibular Dystonia Rating Scale (OMDRS) (Points) [Mean (SD)] | Psychiatric Disease [N (%)] | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Severity | Duration | Degree | Total | ||||||||
TN | 28 | 68.2 (13.6) | 23 (82.1), 5 (17.9) | 6.3 (5.6) | 89.3 7.5) | 19.1 (7.7) | 18.9 (5.1) | 4.8 (1.5) | 4.9 (1.4) | 28.6 (3.6) | 4 (14.3) |
TMD | 53 | 46.1 (17.6) | 39 (73.6), 14 (26.4) | 10.1 (6.5) | 71.3 (19.3) | 13.8 (6.8) | 10.9 (5.9) | 3.6 (1.2) | 3.5 (1.1) | 21.6 (7.5) | 17 (32.1) |
OMD | 89 | 56.4 (16.2) | 60 (67.4), 29 (32.6) | 3.7 (4.5) | 70.3 (19.1) | 12.5 (5.7) | 10.4 (5.2) | 3.5 (1.3) | 3.1 (1.0) | 20.3 (7.5) | 40 (44.9) |
Total | 170 | 55.2 (17.9) | 122 (71.8), 48 (28.2) | 4.9 (5.5) | 73.4 (19.1) | 14.0 (6.8) | 11.6 (5.6) | 3.7 (1.2) | 3.4 (1.1) | 22.1 (7.6) | 61 (35.9) |
Groups | Visual Analog Scale [Mean (SD)] | ||||||
---|---|---|---|---|---|---|---|
Baseline | After Lidocaine Injection | After BoNT/A Injection | |||||
2 Weeks | 4 Weeks | 8 Weeks | 12 Weeks | Endpoint | |||
TN | 89.3 (7.5) | 86.8 (7.3) | 35.1 (6.6) | 25.0 (6.8) | 20.8 (7.0) | 19.5 (7.3) | 11.9 (9.8) |
TMD | 71.2 (19.3) | 65.6 (18.1) | 28.8 (9.4) | 23.2 (8.9) | 21.2 (9.2) | 19.8 (9.8) | 14.2 (9.2) |
OMD | 70.0 (19.1) | 64.5 (17.7) | 32.4 (8.2) | 26.0 (7.5) | 24.0 (7.8) | 23.5 (8.0) | 17.3 (8.5) |
Total | 73.4 (19.1) | 66.3 (17.6) | 31.7 (8.6) | 25.0 (7.9) | 22.6 (8.2) | 21.7 (8.6) | 15.4 (9.1) |
Groups | Pain Frequency (Times/Day) [Mean (SD)] | ||||||
---|---|---|---|---|---|---|---|
Baseline | After Lidocaine Injection | After BoNT/A Injection | |||||
2 Weeks | 4 Weeks | 8 Weeks | 12 Weeks | Endpoint | |||
TN | 19.1 (7.7) | 18.6 (7.5) | 9.8 (4.9) | 5.6 (3.5) | 4.2 (2.9) | 3.7 (2.6) | 3.1 (2.3) |
TMD | 13.8 (6.8) | 13.2 (6.5) | 8.0 (4.7) | 5.3 (3.2) | 4.3 (2.6) | 4.0 (2.6) | 3.3 (2.3) |
OMD | 12.5 (5.7) | 12.0 (5.7) | 7.4 (4.0) | 5.1 (2.9) | 4.0 (2.3) | 3.6 (2.0) | 3.0 (1.7) |
Total | 14.0 (6.8) | 13.5 (6.7) | 8.0 (4.5) | 5.3 (3.1) | 4.2 (2.5) | 3.7 (2.3) | 3.1 (2.0) |
Groups | Pain Scale of Oromandibular Dystonia Rating Scale (OMDRS) (Point) [Mean (SD)] | ||||||
---|---|---|---|---|---|---|---|
Baseline | After Lidocaine Injection | After BoNT/A Injection | |||||
2 Weeks | 4 Weeks | 8 Weeks | 12 Weeks | Endpoint | |||
TN | 28.6 (3.6) | 27.3 (3.5) | 13.1 (3.3) | 7.8 (1.5) | 5.3 (1.9) | 4.6 (2.3) | 3.1 (2.3) |
TMD | 21.6 (7.5) | 20.4 (7.0) | 10.3 (4.1) | 6.5 (3.0) | 4.9 (2.2) | 4.6 (2.4) | 3.3 (2.2) |
OMD | 20.3 (7.5) | 19.1 (7.1) | 9.8 (4.2) | 6.4 (3.2) | 5.3 (2.8) | 5.1 (2.8) | 3.9 (2.3) |
Total | 22.1 (7.6) | 20.4 (7.3) | 10.5 (4.2) | 6.7 (2.9) | 5.2 (2.5) | 4.9 (2.6) | 3.6 (2.3) |
1. Rate the severity of pain during the last week on a scale of 0 to 10, where a score of 1 represents a minimal ache and 10 represents the most excruciating pain imaginable. | |
Best | 0 to 10 |
Worst | 0 to 10 |
Usual | 0 to 10 |
2. Rate the duration of pain | |
None | 0 |
Present < 10% of the time | 1 |
Present 10% to <25% of the time | 2 |
Present 25% to <50% of the time | 3 |
Present 50% to <75% of the time | 4 |
Present ≥ 75% of the time | 5 |
3. Rate the degree to which pain contributes to disability | |
No limitation or interference from pain | 0 |
Pain is quite bothersome but not a source of disability | 1 |
Pain definitely interferes with some tasks a major contributor to disability | 2 |
Pain accounts for some (less than half) disability | 3 |
Pain is a major source of difficulty with activities; separate from this, muscle contraction is also a source of some (less than half) disability | 4 |
Pain is the major source of disability; without it, most impaired activities could be performed quite satisfactorily | 5 |
4. Total Pain Score |
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Yoshida, K. Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia. Toxins 2021, 13, 605. https://doi.org/10.3390/toxins13090605
Yoshida K. Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia. Toxins. 2021; 13(9):605. https://doi.org/10.3390/toxins13090605
Chicago/Turabian StyleYoshida, Kazuya. 2021. "Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia" Toxins 13, no. 9: 605. https://doi.org/10.3390/toxins13090605
APA StyleYoshida, K. (2021). Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia. Toxins, 13(9), 605. https://doi.org/10.3390/toxins13090605