Evidence map›Paper›PMID 30141250›Full record

ArticleBrain and behavior2018

Botulinum toxin A modifies nociceptive withdrawal reflex in subacute stroke patients.

Elena Alvisi, Mariano Serrao, Carmela Conte, Enrico Alfonsi, Cristina Tassorelli, Paolo Prunetti, Silvano Cristina, Armando Perrotta, Francesco Pierelli, Giorgio Sandrini

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain and behavior, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  6. Observational
  7. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Elena AlvisiDepartment of Neurophysiopathology, IRCCS Casimiro Mondino National Neurological Institute, Pavia, Italy.ORCID 0000-0003-1857-2579
Mariano SerraoDepartment of Medical and Surgical Sciences and Biotechnologies, Sapienza, Polo Pontino, University of Rome, Latina, Italy.
Carmela ConteFondazione Don Gnocchi, Milan, Italy.
Enrico AlfonsiDepartment of Neurophysiopathology, IRCCS Casimiro Mondino National Neurological Institute, Pavia, Italy.
Cristina TassorelliDepartment of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Paolo PrunettiDepartment of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Silvano CristinaDepartment of Neurorehabilitation, Casimiro Mondino National Neurological Institute, Pavia, Italy.
Armando PerrottaIRCCS Neuromed, Pozzilli, Isernia, Italy.
Francesco PierelliDepartment of Medical and Surgical Sciences and Biotechnologies, Sapienza, Polo Pontino, University of Rome, Latina, Italy.
Giorgio SandriniDepartment of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
University of Pavia · ITFondazione Istituto Neurologico Nazionale Casimiro Mondino · ITIstituto Neurologico Mediterraneo · ITDon Carlo Gnocchi Foundation · ITPoliclinico Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aims of this study were to evaluate the pattern of the nociceptive withdrawal reflex (NWR) of the upper limb at rest and after injection of Botulinum toxin type A (BoNT-A) in poststroke subacute hemiparetic patients.

methodsFourteen patients with poststroke subacute hemiparesis underwent clinical and instrumental evaluation and BoNT-A injection. Painful electrical stimulation was applied to induce the NWR. Baseline EMG activity and NWR recordings (EMG and kinematic response) were performed at T0, one month (T1), and three months (T2) after the BoNT-A injection, as were Modified Ashworth Scale (MAS) and Functional Independence Measure (FIM) scores.

resultsComparison of results at T0, T1, and T2 revealed significant changes in the MAS score for the elbow (p < 0.001) and wrist joints (p < 0.001) and in the FIM score at T0 and T2. BoNT-A injection had a significant effect on both NWR amplitude and baseline EMG activity in the posterior deltoid (PD) and flexor carpi radialis (FCR) muscles as well as in all averaged muscles. Analysis of elbow kinematics before and after treatment revealed that the reflex probability rates were significantly higher at T1 and T2 than at T0.

conclusionInjection of BoNT-A in the subacute phase of stroke can modify both the baseline EMG activity and the NWR-related EMG responses in the upper limb muscles irrespective of the site of injection; furthermore, the reflex-mediated defensive mechanical responses, that is, shoulder extension and abduction and elbow flexion, increased after treatment. BoNT-A injection may be a useful treatment in poststroke spasticity with a potential indirect effect on spinal neurons.

Indexed as

AgedBotulinum Toxins, Type AElectric StimulationElectromyographyFemaleFollow-Up StudiesHumansMaleMiddle AgedMuscle, SkeletalNociceptive PainParesisReflexStrokeStroke RehabilitationUpper ExtremityBotulinum Toxins, Type Abotulinum toxin Anociceptive withdrawal reflexspasticitystrokeupper limb

Identifiers

PMID30141250
PMCPMC6160647
OpenAlexW2888027209

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.