Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

Nathalie De Beukelaer; Guido Weide; Ester Huyghe; Ines Vandekerckhove; Britta Hanssen; Nicky Peeters; Julie Uytterhoeven; Jorieke Deschrevel; Karen Maes; Marlies Corvelyn; Domiziana Costamagna; Ghislaine Gayan-Ramirez; Anja Van Campenhout; Kaat Desloovere

doi:10.3390/toxins14020139

Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

Nathalie De Beukelaer^*
, Guido Weide
, Ester Huyghe
, Ines Vandekerckhove
, Britta Hanssen
, Nicky Peeters
, Julie Uytterhoeven
, Jorieke Deschrevel
, Karen Maes
, Marlies Corvelyn
, Domiziana Costamagna
, Ghislaine Gayan-Ramirez
, Anja Van Campenhout
, Kaat Desloovere

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (n = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (n = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (n = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, p < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.

Original language	English
Article number	139
Pages (from-to)	1-18
Number of pages	18
Journal	Toxins
Volume	14
Issue number	2
Early online date	14 Feb 2022
DOIs	https://doi.org/10.3390/toxins14020139
Publication status	Published - Feb 2022

Bibliographical note

Funding Information:
Funding: ND was funded by an internal KU Leuven grant, Belgium, 3D-MMAP-C24/18/103. This work was further supported by Internal funding of KU Leuven Biomedical Sciences Group: Fund for Translational Biomedical Research, Belgium, 2019 and the Research Foundation Flanders (FWO), Belgium, G0B4619N. BH and NP were funded by a TBM grant (TAMTA-T005416N). IV and MC were funded by a doctoral grant from FWO (1188921N and 1S78419N, respectively.) Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University Hospitals Leuven/KU Leuven (S59945, approved 18 July 2017; S62187, approved 8 February 2019 and S62645, approved 7 May 2019).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: ND was funded by an internal KU Leuven grant, Belgium, 3D-MMAP-C24/18/103. This work was further supported by Internal funding of KU Leuven Biomedical Sciences Group: Fund for Translational Biomedical Research, Belgium, 2019 and the Research Foundation Flanders (FWO), Belgium, G0B4619N. BH and NP were funded by a TBM grant (TAMTA-T005416N). IV and MC were funded by a doctoral grant from FWO (1188921N and 1S78419N, respectively.) Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University Hospitals Leuven/KU Leuven (S59945, approved 18 July 2017; S62187, approved 8 February 2019 and S62645, approved 7 May 2019).

Keywords

3D freehand ultrasound
Botulinum neurotoxin type-A
Muscle growth rate
Spastic cerebral palsy

Access to Document

10.3390/toxins14020139

Persistent URL (handle)

Persistent link

Cite this

De Beukelaer, N., Weide, G., Huyghe, E., Vandekerckhove, I., Hanssen, B., Peeters, N., Uytterhoeven, J., Deschrevel, J., Maes, K., Corvelyn, M., Costamagna, D., Gayan-Ramirez, G., Van Campenhout, A., & Desloovere, K. (2022). Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy. Toxins, 14(2), 1-18. Article 139. https://doi.org/10.3390/toxins14020139

@article{3375a44a4f214e8689e7ed1509840144,

title = "Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy",

abstract = "Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (n = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (n = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (n = 15). Six months after initiating BoNT-A injection, 17\% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5\% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4\% and −3\%, respectively, p < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.",

keywords = "3D freehand ultrasound, Botulinum neurotoxin type-A, Muscle growth rate, Spastic cerebral palsy",

author = "\{De Beukelaer\}, Nathalie and Guido Weide and Ester Huyghe and Ines Vandekerckhove and Britta Hanssen and Nicky Peeters and Julie Uytterhoeven and Jorieke Deschrevel and Karen Maes and Marlies Corvelyn and Domiziana Costamagna and Ghislaine Gayan-Ramirez and \{Van Campenhout\}, Anja and Kaat Desloovere",

note = "Funding Information: Funding: ND was funded by an internal KU Leuven grant, Belgium, 3D-MMAP-C24/18/103. This work was further supported by Internal funding of KU Leuven Biomedical Sciences Group: Fund for Translational Biomedical Research, Belgium, 2019 and the Research Foundation Flanders (FWO), Belgium, G0B4619N. BH and NP were funded by a TBM grant (TAMTA-T005416N). IV and MC were funded by a doctoral grant from FWO (1188921N and 1S78419N, respectively.) Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University Hospitals Leuven/KU Leuven (S59945, approved 18 July 2017; S62187, approved 8 February 2019 and S62645, approved 7 May 2019). Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = feb,

doi = "10.3390/toxins14020139",

language = "English",

volume = "14",

pages = "1--18",

journal = "Toxins",

issn = "2072-6651",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "2",

}

De Beukelaer, N, Weide, G, Huyghe, E, Vandekerckhove, I, Hanssen, B, Peeters, N, Uytterhoeven, J, Deschrevel, J, Maes, K, Corvelyn, M, Costamagna, D, Gayan-Ramirez, G, Van Campenhout, A & Desloovere, K 2022, 'Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy', Toxins, vol. 14, no. 2, 139, pp. 1-18. https://doi.org/10.3390/toxins14020139

TY - JOUR

T1 - Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

AU - De Beukelaer, Nathalie

AU - Weide, Guido

AU - Huyghe, Ester

AU - Vandekerckhove, Ines

AU - Hanssen, Britta

AU - Peeters, Nicky

AU - Uytterhoeven, Julie

AU - Deschrevel, Jorieke

AU - Maes, Karen

AU - Corvelyn, Marlies

AU - Costamagna, Domiziana

AU - Gayan-Ramirez, Ghislaine

AU - Van Campenhout, Anja

AU - Desloovere, Kaat

N1 - Funding Information: Funding: ND was funded by an internal KU Leuven grant, Belgium, 3D-MMAP-C24/18/103. This work was further supported by Internal funding of KU Leuven Biomedical Sciences Group: Fund for Translational Biomedical Research, Belgium, 2019 and the Research Foundation Flanders (FWO), Belgium, G0B4619N. BH and NP were funded by a TBM grant (TAMTA-T005416N). IV and MC were funded by a doctoral grant from FWO (1188921N and 1S78419N, respectively.) Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University Hospitals Leuven/KU Leuven (S59945, approved 18 July 2017; S62187, approved 8 February 2019 and S62645, approved 7 May 2019). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022/2

Y1 - 2022/2

N2 - Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (n = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (n = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (n = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, p < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.

AB - Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as first-line spasticity treatment in spastic cerebral palsy (SCP). Despite improved clinical outcomes, concerns regarding harmful effects on muscle morphology have been raised. Yet, the risk of initiating BoNT-A to reduce muscle growth remains unclear. This study investigated medial gastrocnemius (MG) morphological muscle growth in children with SCP (n = 26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth of children who remained BoNT-A naive after six months (n = 11) and (b) post-BoNT-A follow-up data of children with a history of BoNT-A treatment (n = 15). Six months after initiating BoNT-A injection, 17% decrease in mid-belly cross-sectional area normalized to skeletal growth and 5% increase in echo-intensity were illustrated. These muscle outcomes were only significantly altered when compared with children who remained BoNT-A naive (+4% and −3%, respectively, p < 0.01). Muscle length growth persevered over time. This study showed reduced cross-sectional growth post-BoNT-A treatment suggesting that re-injections should be postponed at least beyond six months. Future research should extend follow-up periods investigating muscle recovery in the long-term and should include microscopic analysis.

KW - 3D freehand ultrasound

KW - Botulinum neurotoxin type-A

KW - Muscle growth rate

KW - Spastic cerebral palsy

UR - https://www.scopus.com/pages/publications/85124893754

UR - https://www.scopus.com/pages/publications/85124893754#tab=citedBy

U2 - 10.3390/toxins14020139

DO - 10.3390/toxins14020139

M3 - Article

AN - SCOPUS:85124893754

SN - 2072-6651

VL - 14

SP - 1

EP - 18

JO - Toxins

JF - Toxins

IS - 2

M1 - 139

ER -

Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin Type-A Injection in Children with Spastic Cerebral Palsy

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this