Article

To examine effectiveness of botulinum toxin therapy (BoNT), accurate
quantification of the neurological component of underlying spasticity is needed.
PURPOSE: Systematically identify and summarize literature on neurophysiological
methods to test the effectiveness of BoNT, discuss methodological aspects, and
recommend best techniques for clinical and research settings. METHODS: Electronic
databases were searched using specific keywords. Reviews and reference lists were
hand-checked to find relevant studies. Studies in adults with focal limb
spasticity were included. RESULTS: Over 300 articles were scanned for relevance,
and a list of 90 relevant articles was made. After excluding reviews and studies
in healthy controls or non-spasticity related BoNT, 22 articles were reviewed.
Neurophysiological techniques included electromyography (EMG; n = 11), electrical
nerve stimulation (n = 13), transcranial magnetic stimulation (TMS; n = 1),
functional magnetic resonance imaging (fMRI; n = 1), reflex threshold (n = 4),
Achilles tendon reflex (n = 1), reflex latency (n = 1). DISCUSSION: Maximum
M-wave amplitude (M-max) and stretch reflex threshold techniques were
successfully used to measure the neurophysiological effects of BoNT and have high
test-retest reliability. EMG techniques require effective magnitude normalization
techniques and establishing test-retest reliability. CONCLUSION: Serial
electrical nerve stimulation can be incorporated into clinical practice to assist
in follow-up. We recommend using M-max and stretch reflex threshold techniques to
assess the neurophysiological effects.

Langue : ANGLAIS