OnabotulinumtoxinA treatment for MS-tremor modifies fMRI tremor response in central sensory-motor integration areas

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dc.contributor.authorBoonstra, Frederique
dc.contributor.authorEvans, Andrew
dc.contributor.authorNoffs, Gustavo
dc.contributor.authorPerera, Thushara
dc.contributor.authorJokubaitis, Vilija
dc.contributor.authorStankovich, Jim
dc.contributor.authorVogel, Adam
dc.contributor.authorMoffat, Bradford
dc.contributor.authorButzkueven, Helmut
dc.contributor.authorKolbe, Scott
dc.contributor.authorvan der Walt, Anneke
dc.date.accessioned2020-02-24T04:16:47Z
dc.date.available2020-02-24T04:16:47Z
dc.date.issued2020-02
dc.description.abstractBackground: Treatment of tremor in MS is an unmet need. OnabotulinumtoxinA (BoNT-A) has shown promising results; however, little is known regarding its effects on the brain. The clinical presentation of tremor MS is shown to depend on subcortical neural damage and cortical neural plasticity. This study aimed to identify effects of onabotulinumtoxinA (BoNT-A) on brain activation in MS and upper-limb tremor using functional MRI. Methods: Forty-three MS participants with tremor were randomized to receive intramuscular injections of placebo (n = 22) or BoNT-A (n = 21). Tremor was quantified using the Bain score (0–10) for severity, handwriting and Archimedes drawing at baseline, 6 weeks and 12 weeks. Functional MRI activation within two previously identified clusters, ipsilateral inferior parietal cortex (IPL) and remotor/supplementary motor cortex (SMC) of compensatory activity, was measured at baseline and 6 weeks. Results: Treatment with BoNT-A resulted in improved handwriting tremor at 6 weeks (p = 0.049) and 12 weeks (p= 0.014), and tremor severity -0.79 (p=0.007) at 12 weeks. Furthermore, the patients that received BoNT-A showed a reduction in activation within the IPL (p = 0.034), but not in the SMC. The change in IPL activation correlated with the reduction in tremor severity from baseline to 12 weeks (β = 0.608; p = 0.015) in the BoNTA group. No tremor and fMRI changes were seen in the placebo treated group. Conclusion: We have shown that reduction in MS-tremor severity after intramuscular injection with BoNT-A is associated with changes in brain activity in sensorimotor integration regions.en_US
dc.description.sponsorshipThis project was funded by an NHMRC Project Grant (1085461 CIA Van der Walt) and Fellowship (1135683 Vogel). The Bionics Institute receives Operational Infrastructure Support from the Victorian Government. NHMRC 1085461. Botox supplied in an unrestricted grant from Allergan Australia.en_US
dc.identifier.citationBoonstra, F. M. C., A. Evans, G. Noffs, T. Perera, V. Jokubaitis, J. Stankovich, A. P. Vogel, B. A. Moffat, H. Butzkueven, S. C. Kolbe, and A. van der Walt. 2020. OnabotulinumtoxinA treatment for MS-tremor modifies fMRI tremor response in central sensory-motor integration areas. Multiple sclerosis and related disorders. 40: 101984.en_US
dc.identifier.issn2211-0348
dc.identifier.urihttp://repository.bionicsinstitute.org:8080/handle/123456789/387
dc.language.isoenen_US
dc.publisherElsevier B.V.en_US
dc.subjectTremoren_US
dc.subjectOnabotulinumtoxinAen_US
dc.subjectfMRIen_US
dc.subjectNeural plasticityen_US
dc.titleOnabotulinumtoxinA treatment for MS-tremor modifies fMRI tremor response in central sensory-motor integration areasen_US
dc.typeArticleen_US
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