Minamoto VB, Suzuki KP, Bremner SN, Lieber RL, Ward SR.
Botulinum toxin is frequently administered serially to maintain therapeutic muscle paralysis, but repeated dose effects on muscle function are largely unknown. This study characterized the muscle response to 2 onabotulinum toxin (BoNT) injections separated by 3 months.
Animal subjects received a single toxin injection (n=8), 2 BoNT injections separated by 3 months (n= 14), or 1 BoNT and 1 saline injection separated by 3 months (n=8).
The functional effect of 2 serial injections was exponentially greater than the effect of a single injection. While both groups treated with a single BoNT injection had decreased torque in the injected leg by about 50% relative to contralateral legs, the double BoNT injected group had decreased torque by over 95% relative to the pre-injection level. Both single and double BoNT injections produced clear signs of fiber-type grouping.
These experiments demonstrate a disproportionately increased effect of a second BoNT injection.
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