Methods Useful in Optimizing the Treatment of Neuropathies and Targeting Tissues with Cosmetic Botulinum Injections

Abstract

The present invention pertains to methods of determining where, on the skin, a diagnostic, therapeutic, or cosmetic agent is likely to be most effectively applied (e.g., injected), and to methods for monitoring a patient after such an agent has been administered. The monitoring can produce information useful in determining whether a diagnostic, therapeutic (e.g., surgical), or cosmetic regime should be initiated, continued, continued in a modified fashion, or terminated (e.g., for a brief or prolonged period of time). The methods can be repeated periodically and use a non-invasive, in vivo form of digital image speckle correlation (DISC) to track deformation of the skin.

1 . A method for monitoring the effect of one or more injections of a cosmetic agent that induces muscle paralysis, the method comprising:
 (a) prior to the one or more injections of a cosmetic agent that induces muscle paralysis, obtaining a baseline degree of deformation in an area to be treated with the cosmetic agent comprising the steps of:
 (i) taking one or more photographs of a patient's skin in the area to be treated with the cosmetic agent while the patient is at rest; 
 (ii) taking one or more photographs of the patient's skin in the area to be treated with the cosmetic agent while the patient is performing an action; 
 (iii) performing digital image speckle correlation (DISC) analysis on the photographs from steps (a)(i) and (a)(ii), thereby generating a series of displacement vectors that each represents the movement of a pore from its position when the patient is at rest to its position when the patient is performing the action; 
   (b) after the one or more injections of a cosmetic agent that induces muscle paralysis, obtaining a first degree of deformation in the area treated with the cosmetic agent comprising the steps of:
 (i) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is at rest; 
 (ii) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is performing the action; 
 (iii) performing DISC analysis on the photographs from steps (b)(i) and (b)(ii), thereby generating a series of displacement vectors that each represents the movement of a pore from its position when the patient is at rest to its position when the patient is performing the action; 
   (c) comparing the first degree of deformation from step (b) with the baseline degree of deformation from step (a).   
     
     
         2 . The method of  claim 1 , further comprising the steps of:
 (d) after the one or more injections of a cosmetic agent that induces muscle paralysis, obtaining a second degree of deformation in the area treated with the cosmetic agent comprising the steps of:
 (i) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is at rest; 
 (ii) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is performing the action; 
 (iii) performing DISC analysis on the photographs from steps (b)(i) and (b)(ii), thereby generating a series of displacement vectors that each represents the movement of a pore from its position when the patient is at rest to its position when the patient is performing the action; 
   (e) comparing the degree of deformation from step (d) with the first degree of deformation from step (b) and/or with the baseline degree of deformation from step (a).   
     
     
         3 . The method of  claim 1 , wherein the area to be treated comprises skin of the face or neck. 
     
     
         4 . The method of  claim 3 , wherein the area to be treated comprises skin having forehead lines, glabellar lines, or crow's feet. 
     
     
         5 . The method of  claim 3 , wherein the action performed by the patient comprises smiling; moving the jaw, lips or tongue; moving the eyes; or moving the forehead. 
     
     
         6 . The method of  claim 1 , wherein the cosmetic agent that induces muscle paralysis comprises botulinum toxin. 
     
     
         7 . The method of  claim 6 , wherein the cosmetic agent that induces muscle paralysis comprises botulinum toxin type A. 
     
     
         8 . The method of  claim 1 , wherein steps (b) and (c) are repeated one or more times. 
     
     
         9 . The method of  claim 1 , wherein step (b) is performed 1 week, 2 weeks, 4 weeks, 8 weeks 12 weeks, 16 weeks, 20 weeks and/or 24 weeks after the one or more injections of a cosmetic agent that induces muscle paralysis. 
     
     
         10 . A method for monitoring the effect of one or more injections of a cosmetic agent that induces muscle paralysis, the method comprising:
 (a) after the one or more injections of a cosmetic agent that induces muscle paralysis, obtaining a first degree of deformation in an area treated with the cosmetic agent comprising the steps of:
 (i) taking one or more photographs of a patient's skin in the area treated with the cosmetic agent while the patient is at rest; 
 (ii) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is performing an action; 
 (iii) performing digital image speckle correlation (DISC) analysis on the photographs from steps (a)(i) and (a)(ii), thereby generating a series of displacement vectors that each represents the movement of a pore from its position when the patient is at rest to its position when the patient is performing the action. 
   
     
     
         11 . The method of  claim 10 , wherein the method further comprises the steps of:
 (b) obtaining a second degree of deformation in the area treated with the cosmetic agent comprising the steps of:
 (i) taking one or more photographs of a patient's skin in the area treated with the cosmetic agent while the patient is at rest; 
 (ii) taking one or more photographs of the patient's skin in the area treated with the cosmetic agent while the patient is performing the action; 
 (iii) performing DISC analysis on the photographs from steps (b)(i) and (b)(ii), thereby generating a series of displacement vectors that each represents the movement of a pore from its position when the patient is at rest to its position when the patient is performing the action; 
   (c) comparing the second degree of deformation from step (b) with the first degree of deformation from step (a).   
     
     
         12 . The method of  claim 10 , wherein the area treated comprises skin of the face or neck. 
     
     
         13 . The method of  claim 12 , wherein the area to be treated comprises skin having forehead lines, glabellar lines, or crow's feet. 
     
     
         14 . The method of  claim 12 , wherein the action performed by the patient comprises smiling; moving the jaw, lips or tongue; moving the eyes; or moving the forehead. 
     
     
         15 . The method of  claim 10 , wherein the cosmetic agent that induces muscle paralysis comprises botulinum toxin. 
     
     
         16 . The method of  claim 15 , wherein the cosmetic agent that induces muscle paralysis comprises botulinum toxin type A. 
     
     
         17 . The method of  claim 10 , wherein steps (a)(i) to (a)(iii) are repeated one or more times. 
     
     
         18 . The method of  claim 11 , wherein step (b) is performed 1 week, 2 weeks, 4 weeks, 8 weeks 12 weeks, 16 weeks, 20 weeks and/or 24 weeks after the one or more injections of a cosmetic agent that induces muscle paralysis.