Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan 15:480:125692.
doi: 10.1016/j.jns.2025.125692. Epub 2025 Dec 4.

Factors influencing the long-term maintenance of spasticity neurotoxin treatment

Mallory L Hacker  1 , Lucas Chang  2 , Sheffield Sharp  2 , Jack Slatton  2 , Eli A Abdou  2 , Ariana Zarghami  2 , Emily Butler  2 , Kelly Harper  2 , Ashley Eaves  3 , Kevin Berry  3 , C J Plummer  3 , David Charles  2
Affiliations

Factors influencing the long-term maintenance of spasticity neurotoxin treatment

Mallory L Hacker et al. J Neurol Sci. .

Abstract

Introduction: Spasticity is a motor disorder often impairing mobility, daily function, and quality of life. While botulinum neurotoxin (BoNT) is safe and effective for spasticity, treatment discontinuation is common. This study aimed to identify the factors influencing long-term BoNT therapy maintenance among spasticity patients.

Methods: Forty participants with spasticity who received at least five BoNT cycles completed a structured cross-sectional telephone interview. Interviews covered key dimensions of living with spasticity, such as impact on daily activities, experience of pain associated with spasticity, and the broader implications for quality of life. Data were summarized using descriptive statistics.

Results: The cohort (60 % male, aged 45.1 ± 14.8 years) featured multiple etiologies of spasticity, including cerebral palsy (35 %), stroke (20 %), and traumatic brain injury (20 %). Most were treated with onabotulinumtoxinA (36/40), three were receiving abobotulinumtoxinA, and one was treated with incobotulinumtoxinA. Primary reasons for maintaining BoNT treatment included reduction of symptoms (55 %), improvement in mobility/movement (27 %), and relief of pain or tension (12 %). A majority of subjects (95 %) stated their treatment met or exceeded their expectations. Over 90 % of participants maintained a strong relationship with their physician and were well-informed about the therapy, including what to expect from treatment (98 %), potential side effects (90 %), and treatment duration (90 %).

Conclusion: Results suggest spasticity patients are likely to continue treatment if they are properly educated on BoNT therapy, experience improvement in spasms and mobility, and have a strong physician-patient relationship. These findings highlight the importance of effective physician-patient relationships and proper education on BoNT therapy.

Keywords: Botulinum neurotoxin (BoNT); Patient satisfaction; Patient-physician relationship; Quality of life; Spasticity; Treatment continuation.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest M.H. is a shareholder of and consultant for Arena Therapeutics, a company focused on advancing research of DBS for the treatment of patients recently diagnosed with PD, and a consultant for AbbVie. D.C. receives research support from AbbVie, Merz, Ipsen, Supernus, BlueRock, AskBio, Buckwang, Inhibikase, Aeon, and Pharma2B, Income for consulting from Supernus, AbbVie, Ipsen, Revance, Aspen, Abbott, Newronika, Iota, and Amneal, and holds stock in Arena Therapeutics. L.C., SS., J.S., A.Z., E.B., K.H., A.E., K.B., C.P. have no disclosures to report.

LinkOut - more resources