Heterogeneity of the pathophysiological mechanisms of the development of spasticity syndrome in various central nervous system disease


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Abstract

Spasticity is a clinical condition characterized by a velocity-dependent increase in muscle tone or tonic tendon reflexes in combination with other symptoms of damage to the upper motor neuron (UMN). Spasticity is considered a positive symptom of UMN, resulting from a loss of the inhibitory descending effect of the central nervous system (CNS) on the underlying structures and the development of hypersensitivity of reflex arcs at the spinal cord level. Various diseases can lead to the development of spasticity: stroke, cerebral palsy (CP), traumatic brain injury (TBI), spinal cord injury (SCI), multiple sclerosis (MS), neurodegenerative diseases, etc. The article discusses in detail the pathophysiology of spasticity in various diseases, as well as the heterogeneity of the mechanisms of the formation of spasticity syndrome. The results of modern studies on the efficacy of botulinum toxin type A (BTA) in the treatment of spasticity are presented. BTA is effective as an independent method for treating focal spasticity of various etiologies: stroke, CP, SCI, TBI, and MS, and the adjuvant method in combination with other approaches for generalized spasticity. Additional studies are required for the further evaluation of the BTA efficacy in treating spasticity in these diseases.

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About the authors

Svetlana E. Khatkova

National Medical Research Center; Burnazyan Federal Medical Biophysical Center

Email: Hse15@mail.ru
Dr. Sci. (Med.), Professor Moscow, Russia

E. V Kostenko

Pirogov Russian National Research Medical University

Moscow, Russia

M. A Akulov

N.N. Burdenko National Scientific and Practical Center for Neurosurgery

Moscow, Russia

V. P Diaghileva

National Medical Research Center; Burnazyan Federal Medical Biophysical Center

Moscow, Russia

E. A Nikolaev

National Medical Research Center; Burnazyan Federal Medical Biophysical Center

Moscow, Russia

A. A Balbert

Sverdlovsk Regional Clinical Psychoneurological Hospital for War Veterans

Yekaterinburg, Russia

A. S Orlova

Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

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