• Allison Brashear, Anita L McAfee, Elizabeth R Kuhn, and Joanne Fyffe.
• Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. abrashea@iupui.edu
• Arch Phys Med Rehabil. 2004 May 1;85(5):705-9.

ObjectiveTo determine whether botulinum toxin type B (BTX-B) is effective in controlling upper-limb spasticity.DesignA single-site, double-blind, placebo-controlled, randomized trial and open-label study.SettingOutpatient.ParticipantsSubjects with an Ashworth Scale score of 2 or more at the elbow, wrist, and fingers.InterventionsSubjects were injected with 10000 U of BTX-B or placebo at the elbow, wrist, and finger flexors. Main outcome measures Measures recorded at weeks 0, 2, 4, 8, 12, and 16, with a 12-week open-label study. Ashworth Scale score, a global assessment of change (GAC), adverse events and mouse neutralization antibody testing.ResultsBTX-B did not decrease muscle tone in the elbow, wrist, or finger flexors at 10000 U over the 16-week period. A decrease in Ashworth Scale score for the BTX-B patient group was present at the wrist at week 2 of the double-blind study (P=.003) but was not statistically significant at other visits. In the open-label study, improvement was noted at week 4 for the elbow (P=.039), wrist (P=.002), finger (P=.001), and thumb flexors (P=.002). In the double-blind study, the Physician GAC did not reach significance. Dry mouth was reported by 8 of 9 BTX-B subjects in the double-blind study. Mouse neutralization antibodies were negative.ConclusionsOur study does not show a significant decrease in tone from 10000 U of BTX-B. Dry mouth was common.

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