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OnabotulinumtoxinA in the Management of Psychogenic Dystonia

Phase 4
Completed
Conditions
Torticollis, Dystonia
Registration Number
NCT02618889
Lead Sponsor
University of Cincinnati
Brief Summary

The purpose of this research study is to evaluate if patients with psychogenic dystonia treated with onabotulinumtoxinA (BOTOX) injections will demonstrate lower severity and disability at one month and at three months than those having received placebo injections

Detailed Description

Specific Aim 1: To investigate the effect of BoNT on PsyD severity and disability.

We will measure the changes in severity, duration, and incapacitation scores of the Rating Scale for Psychogenic Movement Disorders (RSPMD)10 in adult patients with clinically definite PsyD one month after intramuscular injections with onabotulinumtoxinA in selected muscles of the affected limb(s).

H1: PsyD patients treated with onabotulinumtoxinA injections will demonstrate lower severity and disability at one month than those having received placebo injections.

Specific Aim 2: To investigate the effect of CBT on PsyD severity and disability with and without BoNT pretreatment.

We will examine the extent to which any changes in severity and disability of PsyD, as measured by the RSPMD, after 12 weekly CBT sessions, can be influenced by pre-CBT injections with onabotulinumtoxinA.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Subjects must meet standard criteria for clinically definite PsyD;17
  • PsyD severity and disability score ≥ 10 as measured by the RSPMD (Appendix 1);10
  • Dystonic posturing must have been present without remission for a period longer than 1 year.
  • Between the ages of 18 and 75, inclusive
Exclusion Criteria
  • Prior treatment with any BoNT
  • Presence of clinically unstable medical condition other than the condition under evaluation
  • Concurrent participation in another investigational drug or device study within 30 days prior to study enrollment.
  • We will also exclude subjects with medical disorders deemed at increased risk when exposed to BoNT, including myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis, or other neuromuscular disorders.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Rating Scale for Psychogenic Movement Disorders (RSPMD)4 months

Primary outcome measures will be the combined severity, duration factor, and incapacitation scores (investigator-rated) of the Rating Scale for Psychogenic Movement Disorders (RSPMD, 0-12 per each limb and head \[maximum for all five regions: 60\]) (see Appendix 1).

Secondary Outcome Measures
NameTimeMethod
Clinical Global Impression (CGI) of change4 months

7-point Likert scale ("very much improved," to "very much worse")

Hamilton Depression Rating Scale (HAM-D)4 months

neuropsychiatric measures of depression.

Hamilton Anxiety Rating Scale (HAM-A)4 months

neuropsychiatric measures of depression.

Trial Locations

Locations (1)

Alberto Espay

🇺🇸

Cincinnati, Ohio, United States

Alberto Espay
🇺🇸Cincinnati, Ohio, United States

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