Efficacy of botulinum toxin injection for regional pain by ultrasonography: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2021.06.009

Abstract

Abstract:

Objective

To systemically evaluate the effect of botulinum toxin (BoNT) injection for regional pain (neuropathic and joint pain) by ultrasonography.

Methods

The articles about BoNT injection for patients with regional pain by ultrasonography were searched in Pubmed, Embase, Web of Science, Scopus, CNKI, VIP and Wanfang databases published up to February 2020. Two reviewers independently screened articles and extracted data according to inclusion and exclusion criteria. The STATA 12.0 software was used to perform meta-analysis.

Results

A total of seven studies with 115 patients were included. Meta-analysis demonstrated that the visual analogue scale scores at one month [weighted mean difference (WMD) = 3.68, 95% confidence interval (CI) (2.37, 5.00), Z = 5.50, P < 0.001], there months [WMD = 4.09, 95%CI (1.85, 6.34), Z = 3.58, P < 0.001] and six months [WMD = 5.29, 95%CI (3.27, 7.30), Z = 5.15, P < 0.001] after BoNT injection by ultrasonography were much lower than those before the treatment in patients with regional pain.

Conclusion

The BoNT injection by ultrasonography can effectively relieve patients' neuropathic and joint pain.

Key words: Ultrasonography, Botulinum toxins, Arthralgia, Neuralgia, Meta-analysis

Jiandi He, Guo Tian, Shanyu Yin, Ying Hu, Liyun Zhong, Tianan Jiang, Qiyu Zhao. Efficacy of botulinum toxin injection for regional pain by ultrasonography: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2021, 14(06): 484-488.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhwzzyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6880.2021.06.009

https://zhwzzyxzz.cma-cmc.com.cn/EN/Y2021/V14/I06/484

Figures/Tables 4

References 22

1	Maiarù M, Leese C, Certo M, et al. Selective neuronal silencing using synthetic botulinum molecules alleviates chronic pain in mice[J]. Sci Transl Med, 2018, 10 (450): 7384.
2	Walter U, Dudesek A, Fietzek UM. A simplified ul-trasonography-guided approach for neurotoxin injection into the obliquus capitis inferior muscle in spasmodic torticollis[J]. J Neural Transm (Vienna), 2018, 125 (7): 1037-1042.
3	Roman J, Zampella JG. Demographics of men and minorities in cosmetic clinical trials of botulinum toxin and hyaluronic acid fillers[J]. Dermatol Surg, 2020, 46 (9): 1164-1168.
4	Kwolek MS, Block JE. Maximizing botulinum toxin injections for cosmetic and therapeutic applications with a single use, disposable, exact dose injection assist device[J]. Clin Cosmet Investig Dermatol, 2019 (12): 35-46.
5	Intiso D, Basciani M. Botulinum toxin use in neuro-rehabilitation to treat obstetrical plexus palsy and sialorrhea following neurological diseases: a review[J]. NeuroRehabilitation, 2012, 31 (2): 117-129.
6	Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin[J]. Pharmacol Rev, 1981, 33 (3): 155-188.
7	Go EJ, Ji J, Kim YH, et al. Transient receptor poten-tial channels and botulinum neurotoxins in chronic pain[J]. Front Mol Neurosci, 2021 (14): 772719.
8	Lo C, Mertz D, Loeb M. Newcastle-Ottawa scale: com-paring reviewers′ to authors′ assessments[J]. BMC Med Res Methodol, 2014 (14): 45.
9	Abbasian M, Baghbani S, Barangi S, et al. Outcomes of ultrasound-guided gastrocnemius injection with botulinum toxin for chronic plantar fasciitis[J]. Foot Ankle Int, 2020, 41 (1): 63-68.
10	Wu T, Song HX, Li YZ, et al. Clinical effectiveness of ultrasound guided subacromial-subdeltoid bursa injection of botulinum toxin type A in hemiplegic shoulder pain: a retrospective cohort study[J]. Medicine (Baltimore), 2019, 98 (45): e17933.
11	Galván Ruiz A, Vergara Díaz G, Rendón Fernández B, et al. Effects of ultrasound-guided administration of botulinum toxin (incobotulinumtoxinA) in patients with lateral epicondylitis[J]. Toxins (Basel), 2019, 11 (1): 46.
12	Artusi CA, Bortolani S, Merola A, et al. Botulinum toxin for Pisa syndrome: an MRI-, ultrasound-and electromyography-guided pilot study[J]. Parkinsonism Relat Disord, 2019 (62): 231-235.
13	Rodríguez-Pinero M, Vidal Vargas V, Jiménez Sarmiento AS. Long-term efficacy of ultrasound-guided injection of incobotulinumtoxinA in piriformis syndrome[J]. Pain Med, 2018, 19 (2): 408-411.
14	Al-Al-Shaikh M, Michel F, Parratte B, et al. An MRI evaluation of changes in piriformis muscle morphology induced by botulinum toxin injections in the treatment of piriformis syndrome[J]. Diagn Interv Imaging, 2015, 96 (1): 37-43.
15	Huang YC, Wei SH, Wang HK, et al. Ultrasono-graphic guided botulinum toxin type A treatment for plantar fasciitis: an outcome-based investigation for treating pain and gait changes[J]. J Rehabil Med, 2010, 42 (2): 136-140.
16	Dressler D. Botulinum toxin drugs: brief history and outlook[J]. J Neural Transm (Vienna), 2016, 123 (3): 277-279.
17	Zhai S, Huang B, Yu K. The efficacy and safety of botulinum toxin type A in painful knee osteoarthritis: a systematic review and meta-analysis[J]. J Int Med Res, 2020, 48 (4): 300060519895868.
18	Suzuki M, Saito N, Naritaka N, et al. Scoring system for the prediction of severe acute pancreatitis in children[J]. Pediatr Int, 2015, 57 (1): 113-118.
19	Meng J, Wang J, Lawrence G, et al. Synaptobrevin I mediates exocytosis of CGRP from sensory neurons and inhibition by botulinum toxins reflects their anti-nociceptive potential[J]. J Cell Sci, 2007, 120 (Pt 16): 2864-2874.
20	Cui M, Khanijou S, Rubino J, et al. Subcutaneous administration of botulinum toxin A reduces formalin-induced pain[J]. Pain, 2004, 107 (1-2): 125-133.
21	Chuang YC, Yoshimura N, Huang CC, et al. Intrapro-static botulinum toxin a injection inhibits cyclooxygenase-2 expression and suppresses prostatic pain on capsaicin induced prostatitis model in rat[J]. J Urol, 2008, 180 (2): 742-748.
22	Wei J, Zhu X, Yang G, et al. The efficacy and safety of botulinum toxin type A in treatment of trigeminal neuralgia and peripheral neuropathic pain: a meta-analysis of randomized controlled trials[J]. Brain Behav, 2019, 9 (10): e01409.

纳入研究	研究类型	样本量（例）	年龄（岁，均数或 ± s）	疼痛原因	描述指标	NOS评分（分）
Abbasian等^[9]	前瞻性研究	15	47.3 ± 6.1	慢性足底筋膜炎	①②③	6
Wu等^[10]	回顾性研究	18	61.4 ± 13.0	偏瘫肩痛	①②	6
Galván Ruiz等^[11]	回顾性研究	24	46.8 ± 9	肱骨外上髁炎	①②③	6
Artusi等^[12]	前瞻性研究	15	-	比萨综合征	①	6
Rodríguez-Pinero等^[13]	前瞻性研究	6	57	梨状肌综合征	①③	5
Al-Al-Shaikh等^[14]	回顾性研究	12	46.5	梨状肌综合征	③	5
Huang等^[15]	前瞻性研究	25	54.4 ± 9.6	慢性足底筋膜炎	①②	6

纳入研究	研究类型	样本量（例）	年龄（岁，均数或 ± s）	疼痛原因	描述指标	NOS评分（分）
Abbasian等^[9]	前瞻性研究	15	47.3 ± 6.1	慢性足底筋膜炎	①②③	6
Wu等^[10]	回顾性研究	18	61.4 ± 13.0	偏瘫肩痛	①②	6
Galván Ruiz等^[11]	回顾性研究	24	46.8 ± 9	肱骨外上髁炎	①②③	6
Artusi等^[12]	前瞻性研究	15	-	比萨综合征	①	6
Rodríguez-Pinero等^[13]	前瞻性研究	6	57	梨状肌综合征	①③	5
Al-Al-Shaikh等^[14]	回顾性研究	12	46.5	梨状肌综合征	③	5
Huang等^[15]	前瞻性研究	25	54.4 ± 9.6	慢性足底筋膜炎	①②	6

[1]	Shujie Wei, Pinjing Hui, Yafang Ding, Bai Zhang, Yanhong Yan, Peng Zhou, Yabo Huang. Evaluation of cerebral hemodynamics in patients with unilateral internal carotid artery occlusion undergoing superficial temporal artery-middle cerebral artery bypass [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1046-1055.
[2]	Xuan Zhang, Yutong Ma, Yuqian Miao, Yun Zhang, Shiwen Wu, Xiaochu Dang, Yingying Chen, Zhaoming Zhong, Xuejuan Wang, Miao Hu, Yanfeng Sun, Xiuzhu Ma, Faqin Lyu, Haiyan Kou. Ultrasound assessment of diaphragm function in pediatric patients with Duchenne muscular dystrophy [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1068-1073.
[3]	Lianhua Zhu, Xiang Fei, Peng Han, Bo Jiang, Nan Li, Yukun Luo. Value of high frame rate contrast-enhanced ultrasound in differential diagnosis of gallbladder polyp lesions [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 904-910.
[4]	Meifang Zhang, Ying Tan, Qiaozhen Zhu, Xin Wen, Ying Yuan, Yue Qin, Hongbo Guo, Lingxiu Hou, Wenlan Huang, Guiyan Peng, Shengli Li. Artificial intelligence-based quality control of mid-sagittal plane ultrasound images for first trimester fetal crown-rump length [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 945-950.
[5]	Ruina Zhao, Yuxin Jiang, Tao Chen, Li Zhang, Cheng Chen, Siqi Jin, Xueqi Chen, Xiao Yang, Jianchu Li. Present status and reform demands of continuing medical education for ultrasonic physicians in Beijing [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 966-973.
[6]	Yuhan Zhou, Huan Xiao, Chunjiang Yang, Juan Zhou, Lirong Zhu, Juan Xu, Fangting Mou. Diagnostic value of ultrasound in children with temporary hip synovitis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 795-800.
[7]	Huanyan Liu, Yang Hua, Lingyun Jia, Xinyu Zhao, Beibei Liu. Lumen structure and hemodynamic characteristics of occluded internal carotid artery [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 809-815.
[8]	Lianlian Zhang, Pinjing Hui, Yafang Ding. Clinical value of carotid Doppler ultrasonography in assessing vulnerability of atherosclerotic plaques [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 816-821.
[9]	Yaping Jia, Shu'e Zeng. Ultrasound and pathological characteristics of breast metaplastic carcinoma containing squamous cell carcinoma components [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 844-848.
[10]	Gang Luo, Silin Pan, Taotao Chen, Qian Xu, Zhixian Ji, Sibao Wang, Lingyu Sun. Application of echocardiography in fetal cardiac intervention of pulmonary atresia with intact ventricular septum [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 605-609.
[11]	Jia Huang, Hua Shi, Yuguo Zhang, Jiaqi Hu, Qian Chen. Ultrasonographic features of normal and abnormal fetal left brachiocephalic vein and their clinical significance [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 610-617.
[12]	Ze Yuan, Li Zhuang. Value of ultrasound detection of fetal umbilical artery and middle cerebral artery blood flow in diagnosis of fetal intrauterine distress [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 618-621.
[13]	Jiachun Jiang, Xiaobing Wang, Peirong Chen, Shihao Xu. Clinical value of serological indicators combined with conventional ultrasound and contrast-enhanced ultrasound scoring in diagnosis of primary Sjögren's syndrome [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 622-630.
[14]	Siping Zhang, Wei Liu, Pengcheng Ma. Therapeutic effects of lower extremity mild varus alignment after total knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 808-817.
[15]	Wanglin Luo, Chuanjun Yang, Guoxing Xu, Jianguo Yu, Weidong Sun, Wenjuan Yan, Zhi Feng. Meta analysis on implantation of different grafting materials in open wedge high tibial osteotomy [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 818-826.

Please choose a citation manager

Content to export