Dramatic changes in muscle contractile and structural properties after 2 botulinum toxin injections

Viviane B. Minamoto, Kentaro P. Suzuki, Shannon N. Bremner, Richard L. Lieber*, Samuel R. Ward

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Introduction: Botulinum toxin is frequently administered serially to maintain therapeutic muscle paralysis, but the effect of repeated doses on muscle function are largely unknown. This study characterized the muscle response to 2 onabotulinum toxin (BoNT) injections separated by 3 months. Methods: Animal subjects received a single toxin injection (n=8), 2 BoNT injections separated by 3 months (n=14), or 1 BoNT and 1 saline injection separated by 3 months (n=8). Results: The functional effect of 2 serial injections was exponentially greater than the effect of a single injection. While both groups treated with a single BoNT injection had decreased torque in the injected leg by approximately 50% relative to contralateral legs, the double BoNT injected group had decreased torque by over 95% relative to the preinjection level. Both single and double BoNT injections produced clear signs of fiber-type grouping. Conclusions: These experiments demonstrate a disproportionately greater effect of repeated BoNT injections.

Original languageEnglish (US)
Pages (from-to)649-657
Number of pages9
JournalMuscle and Nerve
Issue number4
StatePublished - Oct 1 2015


  • Botox
  • Denervation
  • Fiber type
  • Muscle physiology
  • Neurotoxin

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Cellular and Molecular Neuroscience
  • Physiology


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