Correlation Analysis Of Clinical Efficacy Of Bolulinum Toxin A In The Treatment Of Primary Meige Syndrome

Objective:To explore the related factors affecting the clinical efficacy of botulinum toxin A(BoNT-A)in the treatment of primary Meige Syndrome.Methods:From August 2017 to October 2019,103 patients with primary Meige Syndrome who received BoNT-A injection for the first time in the Botulinum Toxin Treatment Center,Department of Neurology of the Second Affiliated Hospital of Soochow University and did not receive oral drug therapy related to dystonia after injection were prospectively collected.The clinical indexes such as age,sex,age of onset,course of disease,body mass index and education level were recorded before treatment,and the dystonia symptom scale(Burke-Fahn-Marsden Dystonia Rating Scale,BFMDRS)was used to evaluate the severity and improvement of motor symptoms and disability before treatment and during follow-up.Two methods was used to evaluate the clinical efficacy of patients:they were defined and grouped according to the maximum improvement rate of motor symptoms(<30%/≥30%)and the duration of the curative effect(≤3 months/≥6 months).The correlation between the above clinical indexes and the clinical efficacy of BoNT-A in the treatment of primary Meige Syndrome was analyzed.Results:103 patients in this study:(1)Defined and grouped according to the maximum improvement rate of motor symptoms,the maximum improvement rate was≥30%in 83 cases(80.6%)and<30%in 20 cases(19.4%).Univariate analysis showed that there were significant differences in symptoms first appeared at multiple sites or at a single site,the total movement score,the total disability score,the sub-item score of mouth and speech/swallowing and body mass index before injection between the two groups(P<0.05),but there was no significant difference in age,sex,age of onset,course of disease,dose of botulinum toxin,education level and the sub-item score of eye before injection between the two groups(P>0.05).Further binary Logistic regression analysis of the above related factors showed that there were still significant differences between the two groups in the first onset site and body mass index(P<0.05),indicating that they were independent factors related to the clinical efficacy of BoNT-A in the treatment of primary Meige Syndrome.(2)Defined and grouped according to the duration of curative effect,there were 42 cases(40.8%)in ≤3 months and 33 cases(30.0%)in≥6 months.Univariate analysis showed that there was a significant difference in the maximum improvement rate of motor symptoms between the two groups(P<0.05).There was no significant difference in other clinical indexes such as age,sex,age of onset etc.between the two groups(P>0.05).Binary Logistic regression analysis was carried out with demographic factors and the results showed that there was still a significant difference in the maximum improvement rate of motor symptoms between the two groups(P<0.05).Conclusions:This study found that the clinical efficacy of BoNT-A in the treatment of primary Meige Syndrome was related to the first onset site,body mass index and the maximum improvement rate of motor symptoms,suggesting that patients with multiple first onset sites and high body mass index had poor clinical efficacy of BoNT-A.The patients with maximum improvement rate of motor symptoms had a long duration of efficacy.The conclusions are warrant further replications in larger sample size.