OtherJournal of neuroengineering and rehabilitation2026

Electrical or magnetic nerve stimulation enhance the BoNT/A-mediated muscle paralysis.

Stefanie Honndorf, Klaus Fink

PMID 41620627

WHAT IT FOUND

In mice, applying electrical or magnetic nerve stimulation within two minutes of botulinum toxin injection increased muscle paralysis and duration of effect, but only at lower doses.

No human data is reported, so this does not yet change clinical practice.

Key findings

01Electrical nerve stimulation combined with 20 U/kg BoNT/A increased the peak digit abduction score by 19% and extended the duration of paralysis by 3.2 days compared to BoNT/A alone.

02Magnetic stimulation combined with 30 U/kg BoNT/A significantly increased the digit abduction score from day 7 to day 25 compared to BoNT/A alone.

03The enhancing effect of electrical stimulation disappeared at higher doses (30 and 40 U/kg) due to a ceiling effect where maximum paralysis was already achieved.

STILL TO COME

How it was doneWhat they found

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What it does not show

This is a preclinical study in mice; no human patients were involved. The mouse model does not replicate human spasticity or upper motor neuron syndrome. Magnetic stimulation was technically limited by coil overheating and the small size of mouse nerves, potentially underestimating its effect. The ceiling effect at higher doses limits the generalizability of the finding to standard clinical dosing where maximum paralysis is often targeted. The translation of mouse dose-response data to human clinical outcomes is speculative and not validated.

Declared interests

The study used incobotulinumtoxinA (Xeomin) provided by Merz Pharmaceuticals. The magnetic stimulation device was custom-built by preclinics Research Instruments GmbH. No specific funding declaration or conflict of interest statement regarding author employment or equity is provided in the text.

The easy way to misread this

Do not apply these findings to human practice. This study was conducted in mice, not patients with spasticity. The authors' calculation that this translates to 17 days of longer effect in humans is an extrapolation from animal data that has not been tested in clinical trials.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →


The study

Participants
n=10-18 mice per group
Certainty of evidence
Low

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    Stefanie Honndorf, Klaus Fink Electrical or magnetic nerve stimulation enhance the BoNT/A-mediated muscle paralysis. Journal of neuroengineering and rehabilitation. 2026.

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