A range of interventions for sialorrhea are used in children with cerebral palsy and while BoNT remains one of the most popular approaches for that population a Cochrane review (Walshe et al., 2012) found no strong
evidence of support. Sialorrhea in motor neuron disease (MND) is similarly managed by a variety of interventions
yet a Cochrane review (Young et al., 2011) identified only one RCT, and this revealed some evidence for use of
BoNT to treat sialorrhea in MND. While these neurological populations may share some similarities with PD the
course of the conditions are markedly different. A Cochrane systematic review examining the efficacy and safety
of BoNT for sialorrhea in people with PD is clearly merited considering the topical and significant nature of both
the symptom and the intervention.
A Cochrane systematic review of BoNT for sialorrhea in the PD population will provide a welldefined,
comprehensive and reliable overview of the efficacy of this intervention, based on a full selection of the literature.
It will provide systematic evidence on the benefits and risks of the intervention for sialorrhea in PD and in so
doing will address a significant clinical issue. This information will be highly relevant to, and will have an impact
on, clinical practice and decision making by clinicians, multidisciplinary teams, individuals with PD, their
caregivers, other key stakeholders and decision makers. In the absence of an up to date and rigorous Cochrane
systematic review in the area variable practices in BoNT intervention for sialorrhea in PD will persist. Importantly
this Cochrane systematic review will provide evidence to health policy makers and service planners, and
potentially influence and contribute to the formulation of policies and clinical guidelines on management of
sialorrhea in PD. Furthermore, a Cochrane review investigating the efficacy and safety of BoNT for sialorrhea in
PD will provide direction for necessary future research.
