Botulinum Toxin in Spasticity Management—from Established Practices to Emerging

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

Deadline for manuscript submissions: 30 November 2025 | Viewed by 627

Special Issue Editors


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Guest Editor
Spasticity and Movement Disorders “ReSTaRt”, Unit Physical Medicine and Rehabilitation Section, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Interests: physical medicine; rehabilitation; botulinum toxin: spasticity; movement disorders; neurorehabilitation

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Guest Editor
Spasticity and Movement Disorders “ReSTaRt”, Physical Medicine and Rehabilitation Section, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Interests: rehabilitation medicine; spasticity; ultrasound; botulinum toxin; injection; neurorehabilitation; neurological diseases; mobility limitation; physical functional performance

Special Issue Information

Dear Colleagues,

This Special Issue, titled “Botulinum Toxin in Spasticity Management—from Established Practices to Emerging”, aims to provide a comprehensive examination of both time-tested clinical protocols and the latest innovations in treatment. Contributions are invited to explore the extensive body of research validating the efficacy of botulinum toxin in reducing muscle hyperactivity and improving functional outcomes, alongside emerging strategies that incorporate advanced technologies. In particular, the integration of artificial intelligence—through approaches such as predictive modeling for dose optimization and algorithm-based personalization of treatment regimens—is an emerging trend under investigation to enhance precision in spasticity management. Additional topics of interest include early detection methods, advanced imaging techniques, and digital health solutions that can further refine diagnosis and intervention strategies.

This Special Issue welcomes original research, randomized controlled trials, systematic reviews, meta-analyses, and detailed case studies in human populations.

Dr. Stefania Spina
Dr. Salvatore Facciorusso
Guest Editors

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Keywords

  • botulinum toxin
  • spasticity
  • efficacy
  • artificial intelligence
  • precision medicine

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Published Papers (1 paper)

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Research

11 pages, 1370 KiB  
Communication
Ultrasound-Guided Botulinum Toxin Injections for Hand Spasticity: A Technical Guide for the Dorsal Approach
by Calogero Malfitano, Antonio Robecchi Majnardi, Arianna Pesaresi and Vincenzo Ricci
Toxins 2025, 17(5), 225; https://doi.org/10.3390/toxins17050225 - 3 May 2025
Viewed by 507
Abstract
Spasticity often occurs following neurological disorders such as traumatic brain injury, cerebral palsy, and stroke. Botulinum toxin (BTX) injections, especially when paired with rehabilitation, are among the most effective interventions for these patients. Various techniques for administering BTX injections to the upper limb [...] Read more.
Spasticity often occurs following neurological disorders such as traumatic brain injury, cerebral palsy, and stroke. Botulinum toxin (BTX) injections, especially when paired with rehabilitation, are among the most effective interventions for these patients. Various techniques for administering BTX injections to the upper limb muscles have been described. However, a standardized method for ultrasound-guided injections in the intrinsic muscles of the hand remains quite scant in the literature. The authors suggest a novel dorsal approach to treat the most common abnormal postural patterns in hand spasticity, thumb-in-palm, and intrinsic plus. This approach facilitates access to the muscles while minimizing patient discomfort, as it avoids the need to open forcibly the spastic hand. The adductor pollicis, flexor pollicis brevis, lumbrical, and interosseus muscles have been identified as primary anatomical targets to improve hand posture and function. Standardized sonographic scans are leveled with anatomical illustrations and probe/patient positioning images for interventional procedures. Additionally, tips and techniques for promptly identifying vascular bundles are included to enhance the safety of the procedures. This technical report aims to provide an easy and ready-to-use tool in clinical practice for injecting intrinsic hand muscles in spastic patients, utilizing a novel dorsal approach. Full article
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