A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor

M. F. Brin, K. E. Lyons, J. Doucette, C. H. Adler, J. N. Caviness, C. L. Comella, R. M. Dubinsky, J. H. Friedman, B. V. Manyam, J. Y. Matsumoto, S. L. Pullman, A. H. Rajput, Kapil Dev Sethi, C. Tanner, William C. Koller

Research output: Contribution to journalArticle

139 Citations (Scopus)

Abstract

Objective: To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand. Background: Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor. Methods: One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer. Results: Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness. Conclusion: Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.

Original languageEnglish (US)
Pages (from-to)1523-1528
Number of pages6
JournalNeurology
Volume56
Issue number11
DOIs
StatePublished - Jun 12 2001

Fingerprint

Essential Tremor
Type A Botulinum Toxins
Hand
Tremor
Hand Strength
Injections
Therapeutics
Placebos
Dystonia
Movement Disorders
Wrist
Double-Blind Method
Safety

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Brin, M. F., Lyons, K. E., Doucette, J., Adler, C. H., Caviness, J. N., Comella, C. L., ... Koller, W. C. (2001). A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. Neurology, 56(11), 1523-1528. https://doi.org/10.1212/WNL.56.11.1523

A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. / Brin, M. F.; Lyons, K. E.; Doucette, J.; Adler, C. H.; Caviness, J. N.; Comella, C. L.; Dubinsky, R. M.; Friedman, J. H.; Manyam, B. V.; Matsumoto, J. Y.; Pullman, S. L.; Rajput, A. H.; Sethi, Kapil Dev; Tanner, C.; Koller, William C.

In: Neurology, Vol. 56, No. 11, 12.06.2001, p. 1523-1528.

Research output: Contribution to journalArticle

Brin, MF, Lyons, KE, Doucette, J, Adler, CH, Caviness, JN, Comella, CL, Dubinsky, RM, Friedman, JH, Manyam, BV, Matsumoto, JY, Pullman, SL, Rajput, AH, Sethi, KD, Tanner, C & Koller, WC 2001, 'A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor', Neurology, vol. 56, no. 11, pp. 1523-1528. https://doi.org/10.1212/WNL.56.11.1523
Brin MF, Lyons KE, Doucette J, Adler CH, Caviness JN, Comella CL et al. A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. Neurology. 2001 Jun 12;56(11):1523-1528. https://doi.org/10.1212/WNL.56.11.1523
Brin, M. F. ; Lyons, K. E. ; Doucette, J. ; Adler, C. H. ; Caviness, J. N. ; Comella, C. L. ; Dubinsky, R. M. ; Friedman, J. H. ; Manyam, B. V. ; Matsumoto, J. Y. ; Pullman, S. L. ; Rajput, A. H. ; Sethi, Kapil Dev ; Tanner, C. ; Koller, William C. / A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. In: Neurology. 2001 ; Vol. 56, No. 11. pp. 1523-1528.
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abstract = "Objective: To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand. Background: Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor. Methods: One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer. Results: Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness. Conclusion: Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.",
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TY - JOUR

T1 - A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor

AU - Brin, M. F.

AU - Lyons, K. E.

AU - Doucette, J.

AU - Adler, C. H.

AU - Caviness, J. N.

AU - Comella, C. L.

AU - Dubinsky, R. M.

AU - Friedman, J. H.

AU - Manyam, B. V.

AU - Matsumoto, J. Y.

AU - Pullman, S. L.

AU - Rajput, A. H.

AU - Sethi, Kapil Dev

AU - Tanner, C.

AU - Koller, William C.

PY - 2001/6/12

Y1 - 2001/6/12

N2 - Objective: To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand. Background: Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor. Methods: One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer. Results: Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness. Conclusion: Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.

AB - Objective: To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand. Background: Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor. Methods: One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer. Results: Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness. Conclusion: Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.

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