Muscle volume alterations after first botulinum neurotoxin A treatment in children with cerebral palsy: a 6-month prospective cohort study

作者：Alexander, Caroline; Elliott, Catherine; Valentine, Jane; Stannage, Katherine; Bear, Natasha; Donnelly, Cyril J.; Shipman, Peter; Reid, Siobhan^*

来源：Developmental Medicine and Child Neurology, 2018, 60(11): 1165-1171.

DOI：10.1111/dmcn.13988

• TOXIN TYPE-A
• GASTROCNEMIUS-MUSCLE
• INJECTION FREQUENCY
• MORPHOLOGY
• STRENGTH
• GROWTH
• INTERVENTION
• ATROPHY
• SIZE

AimThis study aimed to track alterations in muscle volume for 6 months in children with cerebral palsy (CP) after the first exposure to botulinum neurotoxin A (BoNT-A), a commonly used focal spasticity treatment. @@@ MethodEleven ambulant children (eight males, three females) with spastic CP, mean age 8 years 10 months (SD 3y 1mo) participated. Participants received injections to the affected gastrocnemius. The muscle volume of the gastrocnemius, soleus, tibialis anterior, and hamstrings was measured using magnetic resonance imaging. Muscle volume was normalized to bone length, and changes analysed relative to baseline. Assessments were conducted 1 week before, and 4 weeks, 13 weeks, and 25 weeks after BoNT-A treatment. @@@ ResultsAll children demonstrated positive clinical and functional gains. Muscle volume of the injected gastrocnemius was found to be significantly reduced at 4 weeks (-5.9%), 13 weeks (-9.4%), and 25 weeks (-6.8%). Significant increases in normalized soleus muscle volume were identified at each follow-up, while hamstrings showed significant increase at 4 weeks only. @@@ InterpretationAbsolute and normalized muscle volume of the injected muscle reduces after first BoNT-A exposure, and does not return to baseline volume by 25 weeks. Hypertrophy is seen in the soleus up to 25 weeks; the volume of the plantar flexor compartment is stable.

• 出版日期2018-11