Muscle Biopsy Substantiates Long-Term MRI Alterations One Year After A Single Dose of Botulinum Toxin Injected into the Lateral Gastrocnemius Muscle of Healthy Volunteers

作者：Schroeder A Sebastian^*; Ertl Wagner Birgit; Britsch Stefanie; Schroeder J Michael; Nikolin Stefan; Weis Joachim; Mueller Felber Wolfgang; Koerte Inga; Stehr Maximilian; Berweek Steffen; Borggraefe Ingo; Heinen Florian

来源：Movement Disorders, 2009, 24(10): 1494-1503.

DOI：10.1002/mds.22661

• botulinum toxin type A (BoNT/A) injection
• muscle MRI
• high signal intensity pattern
• muscle biopsy
• long-term neurogenic atrophy
• neuromuscular junction

Despite numerous clinical and experimental studies on botulinum toxin type A (BoNT/A), long-term alterations of muscle texture and fine structure following BoNT/A treatment have thus far not been Studied in normal human skeletal muscle. After obtaining institutional review board approval, we performed a prospective, placebo-controlled, double-blinded follow-up study on two healthy adults using magnetic resonance imaging (MRI) and muscle biopsy to visualize long-term alterations after a single BoNT/A injection into the lateral head of the gastrocnemius muscle. MRI disclosed a high-signal-intensity pattern in short tau inversion recovery sequences, and a reduction of the cross-sectional area in the BoNT/A-injected, but not in the saline-injected contralateral control muscle (at 6 to 9 months in volunteer A: 73%, in B: 62%; at 12 months in A: 88%, and in B: 78%). Enzyme histochemistry, 12 months after injection, confirmed neurogenic atrophy of muscle fibers only in the BoNT/A-injected muscle. Electron microscopy revealed additional degenerative chances at the neuromuscular junction. The data confirm that MRI is a suitable tool to monitor the long-term effect of BoNT/A on skeletal muscle. Neurogenic muscle atrophy following a single BoNT/A injection should be taken into consideration when repeated BoNT/A injections into the same muscles are proposed.

• 出版日期2009-7-30