The Use of Botulinum Toxin in the Management of Headache Disorders

Overview

Journal Handb Exp Pharmacol

Specialty Pharmacology

Date 2020 Jun 21

PMID 32562057

Citations 4

Authors

Hsiangkuo Yuan

Stephen D Silberstein

Affiliations

Soon will be listed here.

Abstract

Tremendous progress has been made in the past decades for the treatment of headache disorders. Chronic migraine is the most disabling type of headache and requires the use of acute and preventive medications, many of which are associated with adverse events that limit patient adherence. Botulinum toxin (BoNT) serotype A, a neurotoxin derived from certain strains of Clostridium, disrupts neuropeptide secretion and receptor translocation related to trigeminal nociception, thereby preventing pain sensitization through peripheral and possibly central mechanisms. Ever since the first randomized controlled trial on onabotulinumtoxinA (onabotA) for migraine was published two decades ago, onabotA has been the only BoNT formulation approved for use in the prevention of chronic migraine. Superior tolerability and efficacy have been demonstrated on multiple migraine endpoints in many controlled trials and real-life studies. OnabotA is a safe and efficacious treatment for chronic migraine and possibly high-frequency episodic migraine. Further research is still needed to understand its mechanism of action to fully develop its therapeutic potential.

Citing Articles

Breakthroughs on the clinical management of headache and questions that need to be solved.

Liu Y, Yang T, Li J, Xu H, Li S, Xiong L Ibrain. 2023; 7(4):298-308.

PMID: 37786564 PMC: 10529177. DOI: 10.1002/ibra.12003.

The Development of Psychiatric Illness and Chemoprophylaxis of Botulinum Toxin in Migraine: A Narrative Review.

Dhengare A, Fulmali D Cureus. 2023; 14(12):e32998.

PMID: 36712737 PMC: 9879228. DOI: 10.7759/cureus.32998.

Neurotoxins Acting at Synaptic Sites: A Brief Review on Mechanisms and Clinical Applications.

Zhou K, Luo W, Liu T, Ni Y, Qin Z Toxins (Basel). 2023; 15(1).

PMID: 36668838 PMC: 9865788. DOI: 10.3390/toxins15010018.

Comparing the Efficacy, Safety, and Superiority of Calcitonin Gene-Related Peptide Monoclonal Antibodies and Botox in Preventing and Treating Migraines.

Siddiqui M, Shah P, Balani P, Lopez A, Nobleza C, Khan S Cureus. 2021; 13(1):e13002.

PMID: 33542885 PMC: 7847775. DOI: 10.7759/cureus.13002.

References

Manack Adams A, Serrano D, Buse D, Reed M, Marske V, Fanning K . The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results. Cephalalgia. 2014; 35(7):563-78. PMC: 4430584. DOI: 10.1177/0333102414552532. View

Ahmed F, Gaul C, Garcia-Monco J, Sommer K, Martelletti P . An open-label prospective study of the real-life use of onabotulinumtoxinA for the treatment of chronic migraine: the REPOSE study. J Headache Pain. 2019; 20(1):26. PMC: 6734221. DOI: 10.1186/s10194-019-0976-1. View

Aicua-Rapun I, Martinez-Velasco E, Rojo A, Hernando A, Ruiz M, Carreres A . Real-life data in 115 chronic migraine patients treated with Onabotulinumtoxin A during more than one year. J Headache Pain. 2016; 17(1):112. PMC: 5153399. DOI: 10.1186/s10194-016-0702-1. View

Alpuente A, Gallardo V, Torres-Ferrus M, Alvarez-Sabin J, Pozo-Rosich P . Early efficacy and late gain in chronic and high-frequency episodic migraine with onabotulinumtoxinA. Eur J Neurol. 2019; 26(12):1464-1470. DOI: 10.1111/ene.14028. View

Alpuente A, Gallardo V, Torres-Ferrus M, Alvarez-Sabin J, Pozo-Rosich P . Short and Mid-Term Predictors of Response to OnabotulinumtoxinA: Real-Life Experience Observational Study. Headache. 2020; 60(4):677-685. DOI: 10.1111/head.13765. View

Antonucci F, Corradini I, Fossati G, Tomasoni R, Menna E, Matteoli M . SNAP-25, a Known Presynaptic Protein with Emerging Postsynaptic Functions. Front Synaptic Neurosci. 2016; 8:7. PMC: 4805587. DOI: 10.3389/fnsyn.2016.00007. View

Attal N, de Andrade D, Adam F, Ranoux D, Teixeira M, Galhardoni R . Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2016; 15(6):555-65. DOI: 10.1016/S1474-4422(16)00017-X. View

Aurora S, Dodick D, Turkel C, DeGryse R, Silberstein S, Lipton R . OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia. 2010; 30(7):793-803. DOI: 10.1177/0333102410364676. View

Barash J, Arnon S . A novel strain of Clostridium botulinum that produces type B and type H botulinum toxins. J Infect Dis. 2013; 209(2):183-91. DOI: 10.1093/infdis/jit449. View

10.

Black J, Dolly J . Interaction of 125I-labeled botulinum neurotoxins with nerve terminals. II. Autoradiographic evidence for its uptake into motor nerves by acceptor-mediated endocytosis. J Cell Biol. 1986; 103(2):535-44. PMC: 2113823. DOI: 10.1083/jcb.103.2.535. View

11.

Blasi J, Chapman E, Link E, Binz T, Yamasaki S, De Camilli P . Botulinum neurotoxin A selectively cleaves the synaptic protein SNAP-25. Nature. 1993; 365(6442):160-3. DOI: 10.1038/365160a0. View

12.

Blersch W, Schulte-Mattler W, Przywara S, May A, Bigalke H, Wohlfarth K . Botulinum toxin A and the cutaneous nociception in humans: a prospective, double-blind, placebo-controlled, randomized study. J Neurol Sci. 2002; 205(1):59-63. DOI: 10.1016/s0022-510x(02)00313-1. View

13.

Bloudek L, Stokes M, Buse D, Wilcox T, Lipton R, Goadsby P . Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS). J Headache Pain. 2012; 13(5):361-78. PMC: 3381065. DOI: 10.1007/s10194-012-0460-7. View

14.

Blumenfeld A, Binder W, Silberstein S, Blitzer A . Procedures for administering botulinum toxin type A for migraine and tension-type headache. Headache. 2003; 43(8):884-91. DOI: 10.1046/j.1526-4610.2003.03167.x. View

15.

Blumenfeld A, Schim J, Chippendale T . Botulinum toxin type A and divalproex sodium for prophylactic treatment of episodic or chronic migraine. Headache. 2007; 48(2):210-20. DOI: 10.1111/j.1526-4610.2007.00949.x. View

16.

Blumenfeld A, Silberstein S, Dodick D, Aurora S, Turkel C, Binder W . Method of injection of onabotulinumtoxinA for chronic migraine: a safe, well-tolerated, and effective treatment paradigm based on the PREEMPT clinical program. Headache. 2010; 50(9):1406-18. DOI: 10.1111/j.1526-4610.2010.01766.x. View

17.

Blumenfeld A, Silberstein S, Dodick D, Aurora S, Brin M, Binder W . Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes. Headache. 2017; 57(5):766-777. PMC: 5434948. DOI: 10.1111/head.13074. View

18.

Blumenfeld A, Stark R, Freeman M, Orejudos A, Manack Adams A . Long-term study of the efficacy and safety of OnabotulinumtoxinA for the prevention of chronic migraine: COMPEL study. J Headache Pain. 2018; 19(1):13. PMC: 5799088. DOI: 10.1186/s10194-018-0840-8. View

19.

Blumenfeld A, Tepper S, Robbins L, Manack Adams A, Buse D, Orejudos A . Effects of onabotulinumtoxinA treatment for chronic migraine on common comorbidities including depression and anxiety. J Neurol Neurosurg Psychiatry. 2019; 90(3):353-360. PMC: 6518474. DOI: 10.1136/jnnp-2018-319290. View

20.

Brashear A, Gordon M, Elovic E, Kassicieh V, Marciniak C, Do M . Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after a stroke. N Engl J Med. 2002; 347(6):395-400. DOI: 10.1056/NEJMoa011892. View