Botulinum Neurotoxins for the Treatment of Chronic Pain and Headaches

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 135

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Guest Editor
Headache Research, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 1UL, UK
Interests: neurobiology of primary and secondary headaches
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Special Issue Information

Dear Colleagues,

We invite researchers to contribute to the growing body of knowledge on the role of botulinum toxins in the treatment of headaches and pain. While botulinum toxin A is currently approved for the treatment of chronic migraine, its use has expanded widely as an off-label therapy for various other pain conditions, offering promising outcomes for patients who struggle with these complex disorders. Current clinical trials from various industries and research groups in the field of botulinum toxins are exploring the broader potential of their products in treating both episodic and chronic migraine, as well as exploring novel applications in the field of other chronic pain conditions. Further research offering clarity on the mechanism of action of botulinum toxins in sensory systems and their CNS pathways is urgently needed. Looking ahead, the future of botulinum toxin therapies is particularly exciting with the development of recombinant botulinum toxins and non-paralytic formulations. These advancements may further enhance treatment precision and patient outcomes, offering new hope for those who have not found adequate relief through conventional therapies. As the field continues to evolve, your contributions to this important area of research could shape the next generation of headache pain management solutions.

Dr. Anna P. Andreou
Guest Editor

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Keywords

  • botulinum toxins
  • migraine 
  • chronic pain
  • pain management
  • headaches
  • neuropathic pain

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Published Papers (1 paper)

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Research

13 pages, 3351 KiB  
Article
Patient Satisfaction with Aesthetic Outcomes Following OnabotulinumtoxinA Treatment for Chronic Migraine: A Cross-Sectional Study
by Magdalena Boczarska-Jedynak, Marta Bott-Karoń, Karol Marschollek, Mariola Antolak, Maciej Świat and Marta Waliszewska-Prosół
Toxins 2025, 17(6), 292; https://doi.org/10.3390/toxins17060292 - 8 Jun 2025
Abstract
OnabotulinumtoxinA (OnaBoNT-A) is approved for chronic migraine prevention and follows the PREEMPT protocol with injections in the glabellar and forehead regions. While aesthetic changes are considered a side effect, their effect on patient satisfaction has not been thoroughly assessed. This study evaluated patient [...] Read more.
OnabotulinumtoxinA (OnaBoNT-A) is approved for chronic migraine prevention and follows the PREEMPT protocol with injections in the glabellar and forehead regions. While aesthetic changes are considered a side effect, their effect on patient satisfaction has not been thoroughly assessed. This study evaluated patient satisfaction with facial aesthetic outcomes after repeated OnaBoNT-A treatment for chronic migraine. Conducted at specialist headache centers, it included adult patients with chronic migraine who had received at least three OnaBoNT-A cycles. Participants completed a structured questionnaire on demographics, migraine history, facial wrinkles and age perception, appearance satisfaction, psychological impact, treatment satisfaction, and adverse aesthetic events. A total of 124 patients (92.7% female; median age 42.5 years) participated. OnaBoNT-A reduced wrinkle severity (p < 0.0001). Most patients (74.2%) reported aesthetic improvement post-treatment. The majority of patients (76.7%) declared that treatment met or exceeded expectations. 32% reported looking younger post-treatment, with a median perceived age difference of 5 years. Adverse event frequency was similar to pivotal trial outcomes, mostly mild, with no treatment discontinuations. OnaBoNT-A for chronic migraine, following the PREEMPT protocol, provides significant therapeutic benefits and high patient satisfaction regarding aesthetic outcomes. Although aesthetic side effects were generally mild, they were not uncommon. Full article
(This article belongs to the Special Issue Botulinum Neurotoxins for the Treatment of Chronic Pain and Headaches)
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