Author Interviews, JAMA, Neurology / 24.12.2020 Interview with: Dr. Roopa Rajan MD, DM Post Doctoral Fellowship (Movement Disorders) Assistant Professor Department of Neurology AIl India Institute of Medical Sciences New Delhi What is the background for this study? Response: This study was inspired by the need for more effective treatments for patients with disabling hand tremor, particularly dystonic tremor. Dystonic tremor is a movement disorder in which both dystonia (abnormal posturing) and tremor co-exist in the same body part. In general, this common and often disabling disease responds only modestly to oral medications. Surgical treatments such as deep brain stimulation may be offered to persons with severe tremor, however the outcomes are not as robust as seen in other tremor conditions,  for instance, essential tremor. Therefore, there is a critical need for more effective treatments for people living with this disease. Botulinum toxin injections are known to be effective for dystonic tremor affecting the head and voice, although these remain off-label indications. Previous studies using botulinum toxin injections for other hand tremors like essential tremor led to limited clinical application, in part due to transient hand weakness that may be a side effect of botulinum toxin injections. Recently, advances in injection delivery such as electromyographically guided botulinum toxin injections with individualized muscle and dose selections were reported to be beneficial in essential tremor. We built upon this existing data to explore the effects of such a treatment in patients with dystonic hand tremor.   (more…)
Author Interviews, Dermatology, JAMA, Surgical Research / 28.09.2017 Interview with: P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121 What is the background for this study? What are the main findings? Response: As a facial plastic surgeon with an interest in finding treatments for patients with facial paralysis, we are always looking for ways to improve the care that our patients receive. One of those treatments is to treat the effects of abnormal and asymmetric facial motion with botulinum, which decreases the deformity that results from facial nerve disorders by decreasing muscular hyperactivity. This study was based on the fact that there are three commercially available types of botulinum available for treatment of the face. There have been studies that have compared the different types of botulinum for cosmetic purposes, but there have not been any studies that specifically looked to see if there were any differences between the different types of botulinum when used for treatment of facial nerve disorders. The main finding of the study is that the three different types of botulinum are essentially equivalent with the exception being that one type of botulinum, incobotulinum toxin, was slightly less effective than the other two types of botulinum at the 4-week follow up point. Of note, all three types were equivalent at all other time points. (more…)
Author Interviews, Dermatology, JAMA, NIH, Pain Research / 07.08.2015

Edward W. Cowen, MD, MHSc Dermatology Branch, Center for Cancer Research National Cancer Institute Bethesda, Interview with: Edward W. Cowen, MD, MHSc Dermatology Branch, Center for Cancer Research National Cancer Institute Bethesda, Maryland Medical Research: What is the background for this study? Dr. Cowen: Cutaneous leiomyomas are benign smooth muscle proliferations that are associated with pain that is typically not well-controlled by topical remedies or systemic pain medication. Hereditary leiomyomatosis and renal cell cancer is a rare syndrome in which patients may have dozens or even hundreds of these painful tumors. We sought to determine if botulinum toxin injected directly into leiomyomas may ameliorate discomfort and improve quality of life in patients who experience significant pain from cutaneous leiomyomas. Medical Research: What are the main findings? Dr. Cowen: In a double-blinded placebo-controlled study, we found that injection of botulinum toxin was associated with improved skin-related quality of life (p = 0.007) and decreased skin-specific pain (p = 0.048) on the Dermatology Life Quality Index. A trend for decreased pain (p = 0.06) by visual analog score was reported in the botulinum toxin treated group compared to the placebo group. (more…)