Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders

Toxins

Siro Luvisetto³  Parisa Gazerani¹  Carlo Cianchetti²  Flaminia Pavone³ 

[1] Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg East 9100, Denmark; E-Mail:;Former Professor of Child & Adolescent Neuropsychiatry, University of Cagliari, Cagliari 09124, Italy; E-Mail:;National Research Council (CNR) of Italy, Institute of Cell Biology and Neurobiology, Roma 00185, Italy; E-Mail:

关键词: botulinum toxin;    headache;    migraine;    tension-type headache;    cluster headache;    cephalalgias;    animal pain model;    human pain model;    clinical trials;   

DOI  :  10.3390/toxins7093818

来源: mdpi

【 摘 要 】

Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a “glamour” drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.