Zinc as an Adjunctive Therapy for Cervical Dystonia

NCT ID: NCT07140874

Last Updated: 2026-01-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-20

Study Completion Date

2026-12-31

Brief Summary

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The goal of this clinical trial is to evaluate if supplemental zinc can prolong the duration of benefit of botulinum toxin injections in cervical dystonia patients receiving care at the University of Florida.

The main aims are:

1. To evaluate the efficacy of zinc citrate supplementation in prolonging the duration of symptom relief provided by botulinum toxin type A (Botox) injections in cervical dystonia patients.
2. To assess the safety and tolerability of zinc supplementation in this patient population.
3. To analyze the potential influence of zinc supplementation on the quality of life and functional outcomes in cervical dystonia patients receiving Botox.

Researchers will compare zinc citrate to a placebo (a look-alike substance that contains no active drug) to see if zinc works to extend the effects of Botox.

Participants will:

Take zinc citrate or a placebo every day for 3 months, then cross over to the alternative treatment for another 3 months.

Visit the clinic every 3 months for Botox injections, check ups and surveys.

Detailed Description

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Study Design:

* Randomized, single-blind, crossover placebo-controlled trial.
* Participants: Approximately 20 patients diagnosed with cervical dystonia and currently receiving botulinum toxin (BoNT) type A (Botox) injections at the University of Florida (UF) Movement Disorders Clinic with good response to treatment as determined by treating neurologist will be enrolled into this study. The investigators plan to screen 25 patients to allow for screen failures and withdrawals.
* Intervention: Participants will be randomized to receive either zinc citrate 30 mg supplementation or placebo starting immediately after their scheduled BoNT injection for 3 months. At a follow up BoNT injection, they will receive the alternative treatment for another 3 months. The total observation period is 6 months. Standard time between BoNT injections is 3 months.

The UF Movement Disorders Clinic follows approximately 1,500 cervical dystonia patients a year. The investigators do not anticipate any recruitment challenges.

Participants will be recruited during neurology clinic appointments and screening clinic appointments.

* Patients will receive the same pattern of BoNT injections (muscle selection and dose) during the duration of the study.
* Blood serum levels of zinc and vitamin B12 and complete blood counts (CBCs) will be measured at baseline and at the end of the study. Participants will be sent to UF Health Medical lab for blood draws and sample collection.
* Written informed consent will be obtained from each participant before any study-specific procedures or assessments are performed.

Inclusion Criteria:

* Adults aged 18-65 years.
* Diagnosed with cervical dystonia.
* Receiving regular BoNT type A (Botox) injections for at least one year.

Exclusion Criteria:

* Known allergy or intolerance to zinc.
* Significant comorbidities or concurrent medications that could interfere with study outcomes.
* Pregnant or breastfeeding women.
* Already taking a zinc supplement which would exceed tolerable upper intake level in adults (40 mg elemental zinc per day) with addition of zinc study supplement

Conditions

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Cervical Dystonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Zinc first

Encapsulated zinc citrate 30 mg orally daily for 3 months followed by placebo capsule matching zinc daily for 3 months

Group Type EXPERIMENTAL

Zinc citrate

Intervention Type DRUG

Oral zinc citrate 30 mg daily

Placebo

Intervention Type DRUG

Placebo

Placebo first

Placebo capsule matching zinc daily for 3 months, followed by encapsulated zinc citrate 30 mg orally daily for 3 months

Group Type EXPERIMENTAL

Zinc citrate

Intervention Type DRUG

Oral zinc citrate 30 mg daily

Placebo

Intervention Type DRUG

Placebo

Interventions

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Zinc citrate

Oral zinc citrate 30 mg daily

Intervention Type DRUG

Placebo

Placebo

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18-65 years.
* Diagnosed with cervical dystonia.
* Receiving regular BoNT type A (Botox) injections for at least one year.

Exclusion Criteria

* Known allergy or intolerance to zinc.
* Significant comorbidities or concurrent medications that could interfere with study outcomes.
* Pregnant or breastfeeding women.
* Already taking a zinc supplement which would exceed tolerable upper intake level in adults (40 mg elemental zinc per day) with addition of zinc study supplement.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lauren Fanty, MD

Role: PRINCIPAL_INVESTIGATOR

University of Florida

Locations

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Norman Fixel Institute for Neurological Diseases

Gainesville, Florida, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Julie Segura, BA

Role: CONTACT

352-733-2412

References

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Betul Ergul A, Turanoglu C, Karakukcu C, Guler Kazanci E, Altuner Torun Y. Increased vitamin B12 levels in children with zinc deficiency. Int J Vitam Nutr Res. 2017 Sep;87(5-6):247-252. doi: 10.1024/0300-9831/a000444. Epub 2018 Aug 10.

Reference Type BACKGROUND
PMID: 30095365 (View on PubMed)

Rabinovich D, Smadi Y. Zinc. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK547698/

Reference Type BACKGROUND
PMID: 31613478 (View on PubMed)

Shemais N, Elarab AE, ElNahass H. The effect of botulinum toxin A in patients with excessive gingival display with and without zinc supplementation: randomized clinical trial. Clin Oral Investig. 2021 Nov;25(11):6403-6417. doi: 10.1007/s00784-021-03944-2. Epub 2021 May 5.

Reference Type BACKGROUND
PMID: 33950373 (View on PubMed)

Jeng SS, Chen YH. Association of Zinc with Anemia. Nutrients. 2022 Nov 20;14(22):4918. doi: 10.3390/nu14224918.

Reference Type BACKGROUND
PMID: 36432604 (View on PubMed)

Junior HT, dos Santos Melo C, Mendes RR et al. Effects of zinc supplementation on duration and action of botulinum toxin applied to face muscles: A systematic review of randomized clinical trials. Journal of Trace Elements and Minerals. 5. 100080. 10.1016/j.jtemin.2023.100080.

Reference Type BACKGROUND

Xing Y, O'Suilleabhain P. Does Oral Zinc Supplementation Augment the Effect of Botulinum Neurotoxin in Dystonia? Neurology 2015;84(14 Supplement):P4.330. doi: 10.1212/WNL.84.14_supplement.P4.330

Reference Type BACKGROUND

Mallat F, Kaikati J, Kechichian E. Botulinum Toxins and Zinc: From Theory to Practice-A Systematic Review. Clin Neuropharmacol. 2023 Jun 20. doi: 10.1097/WNF.0000000000000557. Online ahead of print.

Reference Type BACKGROUND
PMID: 37335837 (View on PubMed)

Koshy JC, Sharabi SE, Feldman EM, Hollier LH Jr, Patrinely JR, Soparkar CN. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012 Apr;11(4):507-12.

Reference Type BACKGROUND
PMID: 22453589 (View on PubMed)

Other Identifiers

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IRB202500431

Identifier Type: -

Identifier Source: org_study_id

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