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Botulinum Neurotoxin (BoNT) for treatment of functional (psychogenic) jerky movement disorders: a randomized placebo-controlled clinical trial

Y. Dreissen, J. Dijk, J. Gelauff, E. Zoons, M. Contarino, R. Zutt, B. Post, D. van Poppelen, A. Munts, J. Speelman, R. de Haan, J. Koelman, M. Tijssen (Amsterdam, Netherlands)

Meeting: 2017 International Congress

Abstract Number: 724

Keywords: Botulinum toxin: Clinical applications: other, Psychogenic movement disorders(PMD): Treatment

Session Information

Date: Tuesday, June 6, 2017

Session Title: Therapy in Movement Disorders

Session Time: 1:45pm-3:15pm

Location: Exhibit Hall C

Objective: To assess the effectiveness of botulinum neurotoxin (BonT) in patients with functional jerky movement disorders

Background: At least 2–9% of patients seen in movement disorder clinics suffer from functional movement disorders and a substantial part has jerks. Botulinum neurotoxin (BoNT) has emerged as a useful therapy for several hyperkinetic movement disorders. Previous research and our own clinical experience suggest that treatment with BoNT is an effective therapy for jerky movements as well.

Methods: Fourty-eight patients with invalidating functional jerky movement disorders, present for at least one year were included in a double-blind randomized placebo controlled of 16 weeks. The primary endpoint was reached patients showed minimal to major improvement (score 1,2 or 3) on the Clinical Global Impression (CGI)-scale. This was based on videotaped sessions, assessed by two investigators blinded to the allocated treatment. Hereafter all patients received BoNT treatment during one year in order to evaluate the long-term effect. Blinded assessment was repeated at the end.

Results: In the treatment group 16 of 25 (64%) patients reached the primary endpoint, opposed to 13 of 23 patients (57%) in the placebo group. No significant difference was detected. In the open-label follow-up phase 35 of 44 (80%) of patients improved (4 patients were lost to follow-up). This also held for the secondary outcome measures assessing the severity of motor symptoms scored by the investigator as well as the patient. Secondary outcome measures including psychiatric co-morbidity, disability and quality of life failed to reach significance for the trial phase as well as the follow-up.    

Conclusions: Preliminary results show no significant effect of BoNT on functional (jerky) movement disorders. However in the open label follow-up phase the majority of patients improved on motor symptoms. (Netherlands Trial Registry 2478).

To cite this abstract in AMA style:

Y. Dreissen, J. Dijk, J. Gelauff, E. Zoons, M. Contarino, R. Zutt, B. Post, D. van Poppelen, A. Munts, J. Speelman, R. de Haan, J. Koelman, M. Tijssen. Botulinum Neurotoxin (BoNT) for treatment of functional (psychogenic) jerky movement disorders: a randomized placebo-controlled clinical trial [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/botulinum-neurotoxin-bont-for-treatment-of-functional-psychogenic-jerky-movement-disorders-a-randomized-placebo-controlled-clinical-trial/. Accessed July 14, 2025.
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