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Nascimento H, Videira G, Duarte S, Correia C, Andrade C. Impact of delaying botulinum toxin treatment in patients with migraine during the COVID-19 pandemic. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:248-252. [PMID: 37059434 PMCID: PMC10104750 DOI: 10.1055/s-0043-1763490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Due to coronavirus disease 2019 (COVID-19) pandemic response measures, the administration of botulinum toxin (BTX) was delayed for many patients during the first lockdown period in Portugal. OBJECTIVES To review the impact of postponing BTX treatment on migraine control. METHODS This was a retrospective, single-center study. Patients with chronic migraine who had done at least three previous BTX cycles and were considered responders were included. The patients were divided into two groups, one that has had their treatment delayed (group P), and one that has not (controls). The Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) protocol was used. Migraine-related data were obtained at baseline and at three subsequent visits. RESULTS The present study included two groups, group P (n = 30; 47.0 ± 14.5 years; 27 females, interval baseline -1st visit: 5.5 [4.1-5.8] months) and the control group (n = 6; 57.7 ± 13.2 years; 6 females; interval baseline-1st visit 3.0 [3.0-3.2] months). No difference between the groups was present at baseline. When compared to baseline, the number of days/month with migraine (5 [3-6.2] vs. 8 [6-15] p < 0.001), days using triptans/month (2.5 [0-6] vs. 3 [0-8], p = 0.027) and intensity of pain (7 [5.8-10] vs. 9 [7-10], p = 0.012) were greater in the first visit for group P, while controls did not present a significant variation. The worsening of migraine-related indicators decreased in the following visits; however, even in the third visit, it had not returned to baseline. Correlations were significant between the delayed time to treatment and the increase in days/month with migraines at the first visit after lockdown (r = 0.507; p = 0.004). CONCLUSIONS There was a deterioration of migraine control after postponed treatments, with a direct correlation between the worsening of symptoms and the number of months that the treatment was delayed.
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Affiliation(s)
- Henrique Nascimento
- Centro Hospitalar Universitário do Porto, Hospital de Santo António, Serviço de Neurologia, Porto, Portugal
| | - Gonçalo Videira
- Centro Hospitalar Universitário do Porto, Hospital de Santo António, Serviço de Neurologia, Porto, Portugal
| | - Sara Duarte
- Centro Hospitalar Universitário do Porto, Hospital de Santo António, Serviço de Neurologia, Porto, Portugal
| | - Carlos Correia
- Centro Hospitalar Universitário do Porto, Hospital de Santo António, Serviço de Neurologia, Porto, Portugal
| | - Carlos Andrade
- Centro Hospitalar Universitário do Porto, Hospital de Santo António, Serviço de Neurologia, Porto, Portugal
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Movement disorders in coronavirus disease 2019 times: impact on care in movement disorders and Parkinson disease. Curr Opin Neurol 2022; 35:494-501. [PMID: 35787539 DOI: 10.1097/wco.0000000000001075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to outline the impact of the COVID-19 pandemic on movement disorder holistic care, particularly in the care of people with Parkinson disease (PWP). RECENT FINDINGS As the pandemic unfolds, a flurry of literature was published regarding the impact of COVID-19 on people with Parkinson disease including the direct impact of infection, availability of ambulatory care, loss of community-based team care, and acceptability of telemedicine. SUMMARY COVID-19 has impacted the care of PWP in numerous ways. Recognizing infection in PWP poses challenges. Specific long-term complications, including emerging reports of long COVID syndrome is a growing concern. Caregivers and PWP have also been impacted by COVID-19 social isolation restrictions, with radical changes to the structure of social networks and support systems globally. In a matter of weeks, the global community saw an incredible uptake in telemedicine, which brought with benefits and pitfalls. As PWP adapted to virtual platforms and the changing architecture of care delivery, the pandemic amplified many preexisting inequities amongst populations and countries, exposing a new 'digital divide'.
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Rispoli V, Díaz Crescitelli ME, Cavallieri F, Antonelli F, Meletti S, Ghirotto L, Valzania F. Needs and Perceptions of Patients With Dystonia During the COVID-19 Pandemic: A Qualitative Framework Analysis of Survey Responses From Italy. Front Neurol 2022; 13:808433. [PMID: 35785354 PMCID: PMC9243746 DOI: 10.3389/fneur.2022.808433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction:The COVID-19 pandemic and its countermeasures have created changes in both life and healthcare. With the prioritization of COVID-19-related management, the risks and experiences of patients suffering from rare conditions, such as dystonia, during the pandemic remain understudied.Materials and MethodsUsing a framework analysis of a nationwide qualitative online survey, we sought to explore the perspectives of patients with dystonia on their clinical assistance and possible unmet needs during the first pandemic wave. An online survey consisting of 37 items (such as demographic characteristics, dystonia-related features, neurological service provision, therapeutic relationship with the neurologist, perceptions related to virus infection, perceptions about healthcare-related needs, work-related questions, requesting information, and seeking support during the pandemic) was carried out using both close and open-ended questions.ResultsResponses from 62 participants were collected, with most of them from the red zones in Italy, where they were confined indoors. Social isolation was a relevant stressor. Motor and non-motor symptoms increased with detrimental consequences for patients' job and daily functionality. Outpatient clinics and rehabilitation sessions were temporarily shut down, and even telephone/mail support was sparse. Despite efforts, patients felt alone in dealing with dystonia.ConclusionThe first wave of the pandemic and its related restrictions had detrimental consequences for people living with dystonia, and their relevant needs remained unmet. These findings may contribute to implementing remedial healthcare provisions in this pandemic or in future pandemics.
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Affiliation(s)
- Vittorio Rispoli
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | | | - Francesco Cavallieri
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Antonelli
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Stefano Meletti
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
- Neurology Unit, Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Ghirotto
- Qualitative Research Unit - Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- *Correspondence: Luca Ghirotto
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Atici A, Kaysin MY, Akpinar P, Ozkan FU, Aktas I. Rehabilitation processes, stress and depression in patients with spinal cord injury during the COVID-19 pandemic in Turkey: a telephone survey. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Spinal cord injury is a chronic disease that can develop various complications and multisystem dysfunctions. Patients with spinal cord injury need long-term follow up and rehabilitation. During the COVID-19 pandemic, people had to observe social distancing and stay at home. The aim of this study was to evaluate the effects of the COVID-19 pandemic on the rehabilitation and health status of patients with spinal cord injury and assesses their stress levels and depression status. Methods A telephone-based survey was conducted with patients followed up by a spinal cord injury outpatient clinic about rehabilitation processes and any health problems experienced. Stress levels were assessed using the Perceived Stress Scale, while depression was assessed using the Beck Depression Inventory. Demographic characteristics, American Spinal Injury Association Impairment Scale levels, Functional Ambulation Categories and Spinal Cord Independence Measure scores were retrieved from the patients' files. Results The study included 115 patients, none of whom had contracted COVID-19. Of these patients, 44.3% joined the rehabilitation programme before the pandemic, and 3.5% had been able to participate in the rehabilitation programme during the pandemic. An increase in spasticity was recorded in 43.5% of the respondents, an increase of neuropathic pain was recorded in 37.4% of patients and complaints of neurogenic bladder and neurogenic bowel increased by 26.1% and 16.5% respectively. In addition, 4.3% reported novel decubitus ulcers, while 5.2% reported having experienced autonomic dysreflexia episodes. The Perceived Stress Scale scores were 18.32 ± 5.91. No significant difference was detected between the Beck Depression Inventory scores taken at the time of the study and those recorded before the pandemic. Conclusions An insufficiency in the rehabilitation process was noted among patients with spinal cord injuries, accompanied by increased complications. New approaches need to be developed to ensure that the rehabilitation processes of patients with spinal cord injury are not interrupted during a pandemic, and that patients' mental health is not ignored.
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Affiliation(s)
- Arzu Atici
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Meryem Yılmaz Kaysin
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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Schneider SA, Hennig A, Martino D. Relationship between COVID-19 and movement disorders: A narrative review. Eur J Neurol 2021; 29:1243-1253. [PMID: 34918437 DOI: 10.1111/ene.15217] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE The scientific literature on COVID-19 is increasingly growing. METHODS In this paper, we review the literature on movement disorders in the context of the COVID-19 pandemic. RESULTS First, there are a variety of transient movement disorders that may manifest in the acute phase of COVID-19, most often myoclonus, with more than 50 patients described in the literature. New onset parkinsonism, chorea, and tic-like behaviours have also been reported. Movement disorders as a side effect after COVID-19 vaccination are rare, occurring with a frequency of 0.00002-0.0002 depending on the product used, mostly manifesting with tremor. Current evidence for potential long-term manifestations, for example, long COVID parkinsonism, is separately discussed. Second, the pandemic has also had an impact on patients with pre-existing movement disorder syndromes, with negative effects on clinical status and overall well-being, and reduced access to medication and health care. In many parts, the pandemic has led to reorganization of the medical system, including the development of new digital solutions. The movement disorder-related evidence for this is reviewed and discussed. CONCLUSIONS The pandemic and the associated preventive measures have had a negative impact on the clinical status, access to health care, and overall well-being of patients with pre-existing movement disorders.
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Affiliation(s)
| | - Anita Hennig
- Department of Neurology, Ludwig Maximilian University, Munich, Germany
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary and Hotchkiss Brain Institute, Calgary, Alberta, Canada
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Teuschl Y, Bancher C, Brainin M, Dachenhausen A, Matz K, Pinter MM. COVID-19-related delays of botulinum toxin injections have a negative impact on the quality of life of patients with dystonia and spasticity: a single-center ambulatory care study. J Neural Transm (Vienna) 2021; 129:49-53. [PMID: 34689260 PMCID: PMC8541799 DOI: 10.1007/s00702-021-02430-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Botulinum toxin A (BoNT-A) is considered a safe and effective treatment for spasticity and dystonia. Individual interinjection intervals are critical for the maintenance of the effect. In Austria, BoNT outpatient clinics were shutdown from November to December 2020 during COVID-19 control measures, leading to rescheduling of BoNT-A injections. This survey aimed at investigating the influence of injection delays on symptoms, physical functioning, and quality of life (QoL) of the affected patients. METHODS Between April and July 2021, 32 outpatients (21 females, mean age: 63.4 ± 12.1 years) treated ≥ 12 months at the BoNT outpatient clinic Horn-Allentsteig (Austria) and experienced ≥ 2 week injection delays, completed a structured face-to-face questionnaire. RESULTS Indications were dystonia (34%), spasticity (63%), and hyperhidrosis (3%). Injections were delayed by 10 weeks (median, range: 2-15). Muscle cramps increased in 95% of patients with spasticity, muscle twitches in 91% of those with dystonia, and pain in 9% and 60% for dystonia and spasticity, respectively. Overall, 75% reported functional worsening, and deterioration in QoL by 62.6% ± 16.8 (mean ± SD). The impact on QoL correlated with the subjective global improvement induced by BoNT-A (Rs: 0.625; p < 0.001). For 75%, long-term assurance of BoNT-A therapy was very important, and 81% felt their patient rights not respected. CONCLUSIONS COVID-19-related delays in BoNT-A injections illustrate the importance of this therapy for symptom relief, functional outcome, and QoL in patients suffering from involuntary muscle hyperactivity. BoNT-A therapy is essential and has to be guaranteed even in circumstances such as the COVID-19 pandemic.
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Affiliation(s)
- Yvonne Teuschl
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Christian Bancher
- Department of Neurology, Landesklinikum Horn-Allentsteig, Horn, Austria
| | - Michael Brainin
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Alexandra Dachenhausen
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Karl Matz
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria.,Department of Neurology, Landesklinikum Baden-Mödling, Mödling, Austria
| | - Michaela M Pinter
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria. .,Department of Neurology, Landesklinikum Horn-Allentsteig, Horn, Austria.
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Botulinum Toxin Services for Neurorehabiliation: Recommendations for Challenges and Opportunities during the COVID-19 Pandemic. Toxins (Basel) 2021; 13:toxins13080584. [PMID: 34437456 PMCID: PMC8402461 DOI: 10.3390/toxins13080584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic severely impacted the function of medical facilities and rehabilitation services worldwide, including toxin services delivering Botulinum toxin treatments for neuromuscular conditions such as spasticity, dystonia, and sialorrhea. The aim of this paper is to understand how toxin services have dealt with the situation and what strategies have been adopted to continue services. The recommendations are based on a virtual round table held with toxin services experts from different European countries who shared their experiences and discussed the best practices. The challenges for toxin services were reviewed based on the experts' experiences and on relevant literature from 2020 and 2021. A set of recommendations and best practices were compiled, focusing firstly on guidance for clinical practice, including assessing patients' health and risk status and the urgency of their treatment. Secondly, it was discussed how patients on botulinum toxin therapy can be cared for and supported during the pandemic, and how modern technology and tele-medicine platforms can be generally used to optimize effectiveness and safety of toxin treatments. The technological advances prompted by the COVID-19 crisis can result in better and more modern patient care in the future.
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8
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Tarantino D, Gnasso R, Migliore F, Iommazzo I, Sirico F, Corrado B. The effects of COVID-19 pandemic countermeasures on patients receiving botulinum toxin therapy and on their caregivers: a study from an Italian cohort. Neurol Sci 2021; 42:3071-3077. [PMID: 33956258 PMCID: PMC8100930 DOI: 10.1007/s10072-021-05282-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/21/2021] [Indexed: 11/11/2022]
Abstract
COVID-19 outbreak had a huge worldwide impact, and several countermeasures to contain its spread have been adopted, such as the interruption of nonurgent outpatient clinics. We wanted to describe the effects of the national lockdown on the well-being of a cohort of Italian patients with cerebral palsy (CP) receiving botulinum toxin (BT) therapy and of their caregivers. Twenty-five patients receiving BT therapy were surveyed using the structuralized questionnaire by Dressler and Adib Saberi, while the caregivers were assessed using the Caregiver Burden Scale. The lockdown delayed BT therapy by 9 ± 2.8 months. Around 44% of the selected patients noticed increased muscle cramps, 24% increased muscle pain, and 32% both of them. Due to the lockdown, the patient’s quality of life was reduced by 68.4 ± 21.1%. After the lockdown, 100% of patients perceived BT therapy as more important than before. Around 76% of the patients perceived the lockdown as inadequate and felt that their rights were not respected. The overall score of the Caregiver Burden Scale, as regarded before the lockdown, was 29.12 ± 11.63, while the overall score as regarded after the lockdown was 37.44 ± 14.85. The overall score increased, from before the lockdown to after the lockdown, for 92% of caregivers. The BT outpatient clinic’s interruption was seen to significantly worsen the psychophysical condition of subjects with CP and the care burden of their caregivers, exposing them to greater stress than before. Therefore, any kind of BT treatment suspension or delay should be avoided.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Rossana Gnasso
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Federico Migliore
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Irene Iommazzo
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Felice Sirico
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Bruno Corrado
- Department of Public Health, University Federico II of Naples, Naples, Italy.
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Delgado C, Pareés I, Kurtis MM. Patients' Perspective of Dystonia Symptoms during the SARS-CoV-2 Pandemic. Mov Disord 2021; 36:1485-1486. [PMID: 33905574 PMCID: PMC8242438 DOI: 10.1002/mds.28645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 01/27/2023] Open
Affiliation(s)
- Celia Delgado
- Movement Disorders Program, Department of Neurology, Ruber International Hospital, Madrid, Spain
| | - Isabel Pareés
- Movement Disorders Program, Department of Neurology, Ruber International Hospital, Madrid, Spain
| | - Mónica M Kurtis
- Movement Disorders Program, Department of Neurology, Ruber International Hospital, Madrid, Spain
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10
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De Sousa RAL, Improta-Caria AC, Aras-Júnior R, de Oliveira EM, Soci ÚPR, Cassilhas RC. Physical exercise effects on the brain during COVID-19 pandemic: links between mental and cardiovascular health. Neurol Sci 2021; 42:1325-1334. [PMID: 33492565 PMCID: PMC7829117 DOI: 10.1007/s10072-021-05082-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/17/2020] [Indexed: 12/11/2022]
Abstract
The current pandemic was caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The quarantine period during corona virus disease 19 (COVID-19) outbreak might affect the quality of life leading thousands of individuals to diminish the daily caloric expenditure and mobility, leading to a sedentary behavior and increase the number of health disorders. Exercising is used as a non-pharmacological treatment in many chronic diseases. Here, we review the molecular mechanisms of physical exercise in COVID-19 pandemic on mental health. We also point links between exercise, mental, and cardiovascular health. The infection caused by SARS-CoV-2 affects host cells binding to angiotensin-converting enzyme-2 (ACE2), which is the receptor for SARS-CoV-2. If there is not enough oxygen supply the lungs and other tissues, such as the heart or brain, are affected. SARS-CoV-2 enhances ACE2 leading to inflammation and neuronal death with possible development of mood disorders, such as depression and anxiety. Physical exercise also enhances the ACE2 expression. Conversely, the activation of ACE2/Ang 1-7/Mas axis by physical exercise induces an antiinflammatory and antifibrotic effect. Physical exercise has beneficial effects on mental health enhancing IGF-1, PI3K, BDNF, ERK, and reducing GSK3β levels. In addition, physical exercise enhances the activity of PGC-1α/ FNDC5/Irisin pathway leading to neuronal survival and the maintenance of a good mental health. Thus, SARS-CoV-2 infection leads to elevation of ACE2 levels through pathological mechanisms that lead to neurological and cardiovascular complications, while the physiological response of ACE2 to physical exercise improves cardiovascular and mental health.
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Affiliation(s)
- Ricardo Augusto Leoni De Sousa
- Multicenter Post Graduation Program in Physiological Sciences (PMPGCF), Brazilian Society of Physiology, Federal University of the Valleys of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil.
- Neuroscience and Exercise Study Group (Grupo de Estudos em Neurociências e Exercício - GENE), UFVJM, Diamantina, Brazil.
- Laboratório de Treinamento Físico (LETFIS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rodovia MGT 367, Km 583, Alto da Jacuba, n° 5000 - CEP, Diamantina, MG, 39100-000, Brazil.
| | - Alex Cleber Improta-Caria
- Post-Graduate Program in Medicine and Health, Faculty of Medicine, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Roque Aras-Júnior
- Post-Graduate Program in Medicine and Health, Faculty of Medicine, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Edilamar Menezes de Oliveira
- Biodynamics of the Human Body Movement Department, School of Physical Education and Sports, Sao Paulo University - USP, São Paulo, Brazil
| | - Úrsula Paula Reno Soci
- Biodynamics of the Human Body Movement Department, School of Physical Education and Sports, Sao Paulo University - USP, São Paulo, Brazil
| | - Ricardo Cardoso Cassilhas
- Multicenter Post Graduation Program in Physiological Sciences (PMPGCF), Brazilian Society of Physiology, Federal University of the Valleys of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil
- Neuroscience and Exercise Study Group (Grupo de Estudos em Neurociências e Exercício - GENE), UFVJM, Diamantina, Brazil
- Laboratório de Treinamento Físico (LETFIS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rodovia MGT 367, Km 583, Alto da Jacuba, n° 5000 - CEP, Diamantina, MG, 39100-000, Brazil
- Post Graduation Program in Health Sciences (PPGCS), UFVJM, Diamantina, MG, Brazil
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11
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Gonzalez-Martinez A, Planchuelo-Gómez Á, Guerrero ÁL, García-Azorín D, Santos-Lasaosa S, Navarro-Pérez MP, Odriozola-González P, Irurtia MJ, Quintas S, de Luis-García R, Gago-Veiga AB. Effects of the onabotulinumtoxinA follow-up delay in migraine course during the COVID-19 lockdown. Neurol Sci 2021; 42:5087-5092. [PMID: 33768436 PMCID: PMC7994064 DOI: 10.1007/s10072-021-05180-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 03/13/2021] [Indexed: 12/23/2022]
Abstract
Background Face-to-face procedures have been postponed during COVID-19 pandemic. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic. Methods Subjective worsening, intensity of migraine attacks, and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units. Results We included 67 patients with chronic migraine or high-frequency episodic migraine under onabotulinumtoxinA treatment, 65 (97.0%) female, 44.5 ± 12.1 years old. Treatment administration was voluntarily delayed in 14 (20.9%) patients and nine (13.4%) were unable to continue follow-up. Patients with uninterrupted follow-up during lockdown presented 7.6 and 8.1 less monthly days with headache (adjusted p = 0.017) and migraine attacks (adjusted p = 0.009) compared to patients whose follow-up was interrupted, respectively. Conclusion Involuntary delay of onabotulinumtoxinA follow-up in patients with migraine due to COVID-19 pandemic was associated with a higher frequency of headache and migraine attacks. Safe administration of onabotulinumtoxinA during lockdown should be promoted. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05180-8.
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Affiliation(s)
- Alicia Gonzalez-Martinez
- Headache Unit, Department of Neurology, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.,Department of Neurology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Ángel L Guerrero
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - David García-Azorín
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. .,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
| | - Sonia Santos-Lasaosa
- Headache Unit, Department of Neurology, Hospital Clínico Universitario Lozano Blesa and Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain
| | - María Pilar Navarro-Pérez
- Headache Unit, Department of Neurology, Hospital Clínico Universitario Lozano Blesa and Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain
| | | | | | - Sonia Quintas
- Headache Unit, Department of Neurology, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.,Department of Neurology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Ana Beatriz Gago-Veiga
- Headache Unit, Department of Neurology, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.,Department of Neurology, Universidad Autónoma de Madrid, Madrid, Spain
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