NEUROBIOLOGICAL MECHANISMS OF BOTULINUM TOXIN IN THE MANAGEMENT OF CHRONIC PAIN

• DOI: https://doi.org/10.22533/at.ed.0159662611052

• Palavras-chave: Botulinum Toxins, Chronic Pain, Nociception, Neuroinflammation, Calcitonin Gene-Related Peptide, Peripheral Sensitization

• Keywords: Botulinum Toxins, Chronic Pain, Nociception, Neuroinflammation, Calcitonin Gene-Related Peptide, Peripheral Sensitization

• Abstract:

  Chronic pain represents a significant challenge in clinical practice, driving the search for more targeted and safer therapies. In this context, botulinum toxin has been investigated not only for its neuromuscular effects but also for its action on nociceptive pathways. The aim of this study was to analyze the neurobiological mechanisms of botulinum toxin and their clinical implications, integrating experimental and clinical evidence. A literature review was conducted focusing on studies addressing the modulation of neurotransmitters such as CGRP, glutamate, and substance P, as well as receptors such as TRPV1 and neuroinflammatory processes. The results indicate that the toxin reduces the release of nociceptive mediators and interferes with peripheral sensitization, with an indirect impact on central pathways. Clinically, a significant reduction in the frequency and intensity of pain is observed, especially in chronic migraine, although with variability among patients. It is concluded that, although the mechanisms are relatively well described, their clinical translation still has limitations, with the toxin being most effective when incorporated into integrated therapeutic approaches.