On a group level, satisfaction with botulinum neurotoxin (BoNT) treatment in neurological
indications is high. However, it is well known that a relevant amount of patients may not respond as
expected. The aim of this study is to evaluate the BoNT treatment outcome on an individual level
using a statistical single-case analysis as an adjunct to traditional group statistics. The course of
the daily perceived severity of symptoms across a BoNT cycle was analyzed in 20 cervical dystonia
(CD) and 15 hemifacial spasm (HFS) patients. A parametric single-case autoregressive integrated
moving average (ARIMA) time series analysis was used to detect individual responsiveness to BoNT
treatment. Overall, both CD and HFS patients significantly responded to BoNT treatment with
a gradual worsening of symptom intensities towards BoNT reinjection. However, only 8/20 CD
patients (40%) and 5/15 HFS patients (33.3%) displayed the expected U-shaped curve of BoNT efficacy
across a single treatment cycle. CD (but not HFS) patients who followed the expected outcome course
had longer BoNT injection intervals, showed a better match to objective symptom assessments, and
were characterized by a stronger certainty to control their somatic symptoms (i.e., internal medical
locus of control). In addition to standard evaluation procedures, patients should be identified who
do not follow the mean course-of-treatment effect. Thus, the ARIMA single-case time series analysis
seems to be an appropriate addition to clinical treatment studies in order to detect individual courses
of subjective symptom intensities.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:87761 |
| Date | 27 October 2023 |
| Creators | Leplow, Bernd, Pohl, Johannes, Wöllner, Julia, Weise, David |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 508 |
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