ClinicalTrials.gg
Not yet recruitingNCT07822893TOX PARKUpdated Nov 4, 2026

Effect of Botulinum Toxin on Resting Tremor of the Refractory Upper Limb in Parkinsonians

A Phase 3 interventional study of Injection of Dysport then placebo and Injection of placebo then Dysport in PARKINSON DISEASE (Disorder), sponsored by University Hospital, Toulouse. Not yet recruiting at 2 sites in France. Open to participants aged 40 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by University Hospital, Toulouse · Phase 3, Interventional, and Treatment

Updated Nov 4, 2026Start date movedPrimary completion moved+1 moreGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
39
Allocation
Randomized
Ages
40 Years to 80 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 33 studies in Parkinson Disease by University Hospital, Toulouse — 7 open to participants now, 7 under way, 1 of them phase 3. Parkinson Disease · University Hospital, Toulouse.

Planned enrollment
12th of 25
39 · median 38
Started
2026
with 2 others
Phase 3
2 of 33
1 open now
Registered
33rd of 33
by date

Among the 33 studies in Parkinson Disease by University Hospital, Toulouse, this one is the 12th largest by planned enrollment of the 25 interventional ones that give a count, is one of 3 that started in 2026, is one of 2 in phase 3, and was the 33rd registered.

Parkinson Disease

4,573 studies on the registry are indexed under Parkinson Disease; 1,086 are open to participants now.

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Open to participants now

7 of the 33 studies in Parkinson Disease by University Hospital, Toulouse are open now, in 4 countries. Recruiting first, the newest first:

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By country, each count listing its studies:

All 7 open studies →

Where they have run

Who these studies take

Of the 748 Parkinson Disease studies recruiting now, 311 (42%) set no upper age limit and 127 (17%) stop at 75 or younger; 63 take children under 18; 189 take healthy volunteers.

This study: 40 Years to 80 Years · all sexes · no healthy volunteers.

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02

Study summary

Tremor is one of the most common symptoms in Parkinson Disease (PD), affecting almost 60% of patients. There is currently no specific treatment for tremor in PD, and 30% of patients develop drug-resistant tremor, making its management more complex. Botulinum toxin (BT) is widely used in neurology, but few studies have been carried out on the effect of BT in parkinsonian tremor without consensus on its management in parkinsonian patients. In this study, the investigators therefore propose to evaluate the effect of BT injected using precision medicine in the treatment of refractory resting tremor in patients with PD, compared with placebo injection.

Read the detailed description

Parkinson's disease (PD) is the second most common neurodegenerative disease. Tremor is one of the most common symptoms, affecting almost 60% of patients. It has a considerable impact on their quality of life, causing psychosocial stress in over 25% of patients. There is currently no specific treatment for tremor in PD, and 30% of patients develop drug-resistant tremor, making its management more complex. Botulinum toxin (BT) has been approved in France in 1994 and is widely used in neurology. To date, few studies have been carried out on the effect of BT in parkinsonian tremor: most have been open-label and have mixed parkinsonian patients and patients with essential tremor. Therefore, there is no consensus on the management of tremor in patients with PD. Nevertheless, there is a real need for treatment of refractory tremor, particularly in elderly patients, patients who cannot tolerate high doses of medication or patients who are ineligible for neurostimulation. In this study, the investigators therefore propose to evaluate the effect of BT injected using precision medicine in the treatment of refractory resting tremor in parkinsonian patients, compared with placebo injection. The investigators hypothesize that BT treatment improves parkinsonian tremor in a clinically relevant way compared to placebo injection using an optimized and personalized injection technique (doses of toxin and muscles injected). The drug will be injected intramuscularly into the muscles identified as responsible for the tremor, by an investigator specialising in injections. PD patients with resistant tremor will be included and followed up in this study for one year. BT or placebo will be injected at 6 months apart in all patients thanks to the cross over study design.

03

Conditions studied

  • PARKINSON DISEASE (Disorder)

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Keywords

  • parkinson disease
  • resistant tremor
  • botulinic toxin
  • precision medicine
04

Who can participate

Ages eligible
40 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients with PD defined according to UKPDSBB criteria;
  • Men and women aged between 40 and 80 years;
  • Patients with troublesome rest tremor assessed by the CGI-S scale ≥ 3 and persistent despite the initiation of ≥ two anti-parkinsonian treatments (levodopa, dopaminergic agonist, anticholinergic), which defines drug-resistant parkinsonian tremor;
  • Patients naïve to botulinum toxin treatment;
  • Patients whose antiparkinsonian treatment has been stable for at least 4 weeks prior to inclusion and for the duration of the study;
  • Person affiliated with or beneficiary of a social security scheme;
  • Free, informed, and written consent signed by the participant and the investigator (no later than the day of inclusion and before any examination required by the research).

Exclusion criteria

Exclusion Criteria:

  • Patients with tremors related to a pathology other than PD;
  • Patients with atypical parkinsonian syndrome;
  • Patients treated with drugs which have the adverse effect of causing the appearance or aggravation of tremors: lithium, sodium valproate, levetiracetam, benzodiazepines, , thyroid hormones, ciclosporin, alcohol, tricyclic antidepressants, theophillyne, terbutaline, antipsychotics (excluding clozapine) ;
  • Patients with to the active substance or to one of the (human albumin, lactulose);
  • patients with atrophy of the target muscle
  • patients with a urinary tract infection at the time of treatment if the patient suffers from urinary incontinence due to neurological detrusor overactivity
  • patients with a history of swallowing or respiratory disorders;
  • patients with marked clinical or subclinical neuromuscular transmission deficits (e.g., myasthenia gravis);
  • patients with fixed contractures Pregnant or breastfeeding women;
  • Women of childbearing age without effective ;
  • Patients under legal guardianship, tutorship, or curatorship.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
39 participants (estimated)

Study arms

  • Experimental
    Botulinum toxin followed by placebo arm

    In this cross-over study, the patient will be his or her own control. The patient will receive both treatments at 6 months apart: DYSPORT followed by the placebo (the order of injections has been randomly assigned).

    Drug: Injection of Dysport then placebo

  • Experimental
    Placebo followed by botulinum toxin arm

    In this cross-over study, the patient will be his or her own control. The patient will receive both treatments at 6 months apart: placebo followed by DYSPORT (the order of injections has been randomly assigned).

    Drug: Injection of placebo then Dysport

Interventions

  • DrugInjection of Dysport then placebo

    Both treatments, first DYSPORT 500UI for 6 months then placebo, also for 6 months, will be administered intramuscularly using the same schedule and procedures thus allowing the blind to be maintained. The two injections will be carried at 6 months apart: the drug will be injected intramuscularly, into the muscles identified as responsible for the tremor, by an investigator specialized in carrying out injections. The doses injected will depend on the severity of the tremor and the number of muscles injected, which is conditioned by the tremor phenotype.

  • DrugInjection of placebo then Dysport

    Both treatments, first placebo for 6 months then DYSPORT 500UI, also for 6 months, will be administered intramuscularly using the same schedule and procedures thus allowing the blind to be maintained. The two injections will be carried at 6 months apart: the drug will be injected intramuscularly, into the muscles identified as responsible for the tremor, by an investigator specialized in carrying out injections. The doses injected will depend on the severity of the tremor and the number of muscles injected, which is conditioned by the tremor phenotype.

06

What researchers measure

Primary outcomes

  1. The effect of botulinum toxin on the resting tremor of the upper limb refractory to treatments

    It will be assessed by the PGI-C (Patient Global Impression-Change) score completed by the patient six weeks after injection and compared between treatments.

    Time frame: 7,5 months

Secondary outcomes

  1. The effect of botulinum toxin on the resting tremor: evolution evaluated by the investigator

    It will be assessed by the CGI-C (Clinician Global Impression-Change) investigator-level change score, six weeks after injection.

    Time frame: 7,5 months

  2. The effect of botulinum toxin on the resting tremor: severity evaluated by the investigator

    It will be assessed by the delta of severity scores at the CGI-S (Clinician Global Impression-Severity) investigator level between injection and six weeks post-injection.

    Time frame: 7,5 months

  3. The effect of botulinum toxin on the resting tremor: amplitude evaluated by the investigator

    It will be assessed by the delta of the item score 3.17 (amplitude) at the MDS-UPDRS III investigator level between injection and six weeks post-injection.

    Time frame: 7,5 months

  4. The effect of botulinum toxin on the resting tremor: patient-assessed severity

    It will be assessed by the delta of severity scores at the patient scale PGI-S (Patient Global Impression-Severity) between injection and six weeks post-injection.

    Time frame: 7,5 months

  5. The effect of botulinum toxin on the postural tremor: evolution evaluated by the investigator

    It will be assessed by the change score at the CGI-C investigator scale, at six weeks post-injection.

    Time frame: 7,5 months

  6. The effect of botulinum toxin on the postural tremor: severity evaluated by the investigator

    It will be assessed by the delta of severity scores at the CGI-S investigator level between injection and six weeks post-injection.

    Time frame: 7,5 months

  7. The effect of botulinum toxin on the postural tremor: amplitude evaluated by the investigator

    It will be assessed by the delta of item 3.21 (amplitude) at the MDS-UPDRS III investigator level between injection and six weeks post-injection.

    Time frame: 7,5 months

  8. The effect of botulinum toxin on the postural tremor: patient-assessed change

    It will be assessed by the PGI-C scale score completed by the patient six weeks after injection and compared between groups.

    Time frame: 7,5 months

  9. The effect of botulinum toxin on the postural tremor: patient-assessed severity

    It will be assessed by the delta of severity scores on the PGI-S (Patient Global Impression-Severity) scale completed by the patient between the injection and six weeks post-injection.

    Time frame: 7,5 months

  10. The effect of botulinum toxin on the Parkinsonian tremor (at rest and postural): duration

    It will be assessed by the proportion of time the patient has a tremor, measured using an actimeter for 7 days prior to the assessment visit.

    Time frame: 12 months

  11. The effect of botulinum toxin on the Parkinsonian tremor (at rest and postural): amplitude

    It will be assessed by the mean angular amplitude measured using motion sensors placed on the hand and arm at six weeks post-injection.

    Time frame: 7,5 months

  12. The effect of botulinum toxin on the Parkinsonian tremor (at rest and postural): frequency

    It will be assessed by the mean frequency in Hertz (Hz) measured using motion sensors placed on the hand and arm at six weeks post-injection.

    Time frame: 7,5 months

  13. The effect of botulinum toxin on the patient's experience: life quality

    It will be assessed by the delta of the patient's quality of life score on the PDQ-39 self-administered questionnaire between injection and six weeks post-injection.

    Time frame: 7,5 months

  14. The effect of botulinum toxin on the patient's experience: daily life activities

    It will be assessed by the delta of the daily life activities score by the MDS-UPDRS scale, parts one and two between injection and six weeks post-injection.

    Time frame: 7,5 months

  15. The safety of use for botulinum toxin: muscle weakness (1)

    It will be assessed by the delta of the measurement in Newton of the manual dynamometer, for the treated hand, between injection and six weeks after injection.

    Time frame: 7,5 months

  16. The safety of use for botulinum toxin: muscle weakness (2)

    It will be assessed by the delta of the severity scores for muscle weakness in the treated hand, on the PGI-S (Patient Global Impression Severity) scale, completed by the patient between the injection and six weeks after the injection.

    Time frame: 7,5 months

  17. The safety of use for botulinum toxin: adverse events

    It will be assessed by all the adverse events collected during the study.

    Time frame: 12 months

Other outcomes

  1. The factors associated with good response to botulinum toxin treatment

    The correct response to treatment will be determined from the scores of the PGI-S patient scale on the severity of the tremor and on the severity of the muscle weakness.

    Time frame: 12 months

07

Study locations

2 sites
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Dec 2026; primary completion for Dec 2029, 36 months later.

Of 67 phase 3 interventional studies under Parkinson Disease, half reached primary completion within 35 months of starting (the median), counting those still running; a quarter within 22 and three quarters within 56. This study's planned 36 months is close to that.

Since we started tracking on Sep 25, 2026, the dates moved once, on Nov 4, 2026: start Oct 2026 → Dec 2026, primary completion Oct 2029 → Dec 2029 and completion Oct 2029 → Dec 2029.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Sep 10, 2026
First posted
Sep 16, 2026
StartEst.
Dec 2026was Oct 2026
Primary completionEst.
Dec 2029was Oct 2029
CompletionEst.
Dec 2029was Oct 2029
Last update
Nov 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Start date
Oct 2026→Dec 2026
Nov 4, 2026
Primary completion
Oct 2029→Dec 2029
Nov 4, 2026
Study completion
Oct 2029→Dec 2029
Nov 4, 2026
Show all 1 update
  1. Nov 4, 2026
    Start date Oct 2026→Dec 2026
    Primary completion Oct 2029→Dec 2029
    Study completion Oct 2029→Dec 2029
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07822893
Responsible party
Sponsor
First posted
Sep 16, 2026
Start date
Dec 2026 (estimated)
Primary completion
Dec 2029 (estimated)
Completion
Dec 2029 (estimated)
Last update
Nov 4, 2026

Study contacts

Clémence Leung, MD
Contact
leung.c@chu-toulouse.fr
05 61 77 61 76 ext. +33
Clémence Leung, MD
principal investigator · University Hospital, Toulouse

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.

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