Botulinum Neurotoxins in the Management of Movement Disorders: Clinical and Therapeutic Innovations

Botulinum neurotoxins (BoNT) have become a cornerstone in the treatment of hyperkinetic movement disorders, offering targeted and reversible chemodenervation that has significantly improved patient outcomes. Over recent decades, the use of BoNT has evolved beyond its initial indications for cervical dystonia and blepharospasm, now encompassing hemifacial spasm, oromandibular dystonia, sialorrhea, limb dystonias, tremor, muscle hypertonia in Parkinsonism, and select functional and cerebellar syndromes. Technological advances such as ultrasound, electromyography (EMG), and kinematic guidance have increased precision in targeting affected muscles, while new serotypes and formulation sciences expand therapeutic possibilities. Despite these developments, there remains considerable heterogeneity in outcomes, largely attributable to variation in patient phenotypes, targeting methodologies, and inconsistencies in outcome assessment. Thus, efforts are needed to unify our understanding and optimize the delivery and monitoring of BoNT therapies across movement disorder populations.This Research Topic aims to advance the consistency and effectiveness of BoNT therapies for movement disorders by consolidating multidisciplinary expertise. Key objectives include personalizing patient assessment and target identification, unifying outcome measurement standards, and incorporating advanced guidance technologies into routine clinical care. We also seek strategies to address non-responsiveness—whether from technique, disease biology, or antibody formation—and to clarify dosing, scheduling, and combination therapies. By unifying clinical, real-world, and translational research, the Research Topic will foster consensus, spotlight innovative practices, and establish priorities to enhance quality, access, and equity in the use of BoNT for movement disorders.To gather further insights into the advances and challenges of botulinum toxins in the management of movement disorders, we welcome submissions across a diverse range of manuscript types supported by the journal—including Original Research, Brief Research Reports, Perspectives, Protocols, Mini-Reviews, and more—exploring, but not limited to, the following themes:- Precision injection techniques and guidance methods, including ultrasound, EMG, and kinematic approaches- Protocols tailored to specific indications (dystonia subtypes, tremor, myoclonus, tics, hemifacial spasm, sialorrhea, and muscle hypertonia in Parkinsonism/atypical Parkinsonism)- Clinician- and patient-reported outcome measures, along with the use of digital biomarkers and wearable technologies- Safety, immunogenicity, antibody formation, and secondary non-response management- Mechanistic insights and therapeutic innovations, including novel serotypes, formulations, and delivery devices- Integration of BoNT with multimodal care approaches such as deep brain stimulation, oral pharmacotherapy, and allied health interventions- Health services themes including cost-effectiveness, training, access, and implementation scienceSubmissions are expected to detail study methodology, injection protocols, and outcome assessment to ensure reproducibility and generalizability across diverse patient populations.Articles accepted after peer review will be published and appear online as soon as approved for publication.Sign up now to participate in this exciting Research Topic. Topic editors: Lucio Marinelli, Nutan Sharma, Anna Castagna, Kazuya Yoshida Source: https://www.frontiersin.org/research-topics/77132/botulinum-neurotoxins-in-the-management-of-movement-disorders-clinical-and-therapeutic-innovations