Trial reportJournal of neurology, neurosurgery, and psychiatry2019
Botulinum neurotoxin treatment in jerky and tremulous functional movement disorders: a double-blind, randomised placebo-controlled trial with an open-label extension.
Trial report in Journal of neurology, neurosurgery, and psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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.
Who cites it
14 citing papers in PubMed, 36 citations in OpenAlex.
- Treatment of Functional Neurological Disorders.Journal of clinical neurology (Seoul, Korea) · 2026Review
- Functional Movement Disorder: Evolving Mechanisms, Diagnostic Precision, and Personalized Multidisciplinary Care.Movement disorders clinical practice · 2025Review
- Botulinum Toxin for the Treatment of Tremors.Toxins · 2025Review
- Orthodontic considerations for managing patients with functional movement disorders: a narrative review and clinical guide.Frontiers in dental medicine · 2025Review
- Sustained shoulder elevation posture: an under-recognized functional movement disorder phenotype.Brain communications · 2025Article
- Treatment outcomes in functional neurological disorder: a systematic review and meta-analysis exploring the influence of symptom chronicity.BMJ neurology open · 2025Article
- Functional Movement Disorders: Updates and Clinical Overview.Journal of movement disorders · 2024Article
- Functional neurological disorder: new subtypes and shared mechanisms.The Lancet. Neurology · 2022Review
- Periorbital injections of botulinum toxin a: a novel therapeutic option for convergence spasm in neuropsychiatric disorders.Journal of neurology · 2022Article
- Decade of progress in motor functional neurological disorder: continuing the momentum.Journal of neurology, neurosurgery, and psychiatry · 2021Review
- Botulinum neurotoxin (BoNT) treatment in functional movement disorders: long-term follow-up.Journal of neurology, neurosurgery, and psychiatry · 2020Article
- A Moving Residual Limb: Botulinum Toxin to the Rescue.Translational neuroscience · 2020Article
- Functional Dystonia: Differentiation From Primary Dystonia and Multidisciplinary Treatments.Frontiers in neurology · 2020Review
- The chronnectome as a model for Charcot's 'dynamic lesion' in functional movement disorders.NeuroImage. Clinical · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo study the effect of botulinum neurotoxin (BoNT) treatment in jerky and tremulous functional movement disorders (FMD).
methodsPatients with invalidating, chronic (>1 year) symptoms were randomly assigned to two subsequent treatments with BoNT or placebo every 3 months with stratification according to symptom localisation. Improvement on the dichotomised Clinical Global Impression-Improvement scale (CGI-I) (improvement vs no change or worsening) at 4 months, assessed by investigators blinded to the allocated treatment was the primary outcome. Subsequently all patients were treated with BoNT in a ten month open-label phase.
resultsBetween January 2011 and February 2015 a total of 239 patients were screened for eligibility of whom 48 patients were included. No difference was found on the primary outcome (BoNT 16 of 25 (64.0%) vs Placebo 13 of 23 patients (56.5%); proportional difference 0.075 (95% CI -0.189 to 0.327; p=0.77). Secondary outcomes (symptom severity, disease burden, disability, quality of life and psychiatric symptoms) showed no between-group differences. The open-label phase showed improvement on the CGI-I in 19/43 (44.2%) of remaining patients, with a total of 35/43 (81.4%) improvement compared with baseline.
conclusionsIn this double-blind randomised controlled trial of BoNT for chronic jerky and tremulous FMD, we found no evidence of improved outcomes compared with placebo. Motor symptoms improved in a large proportion in both groups which was sustained in the open-label phase. This study underlines the substantial potential of chronic jerky and tremulous FMD patients to recover and may stimulate further exploration of placebo-therapies in these patients. TRIAL REGISTRATION NUMBER: NTR2478.
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Registered trials
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.