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Amorelli G, Bruno V, Martino D, Furtado S. An Unexpected Benefit From Face Masks During COVID-19. Can J Neurol Sci 2024; 51:339-340. [PMID: 36715064 DOI: 10.1017/cjn.2023.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Gabriel Amorelli
- Department of Clinical Neurosciences, University of Calgary, Calgary, AlbertaT2N 1N4, Canada
| | - Veronica Bruno
- Department of Clinical Neurosciences, University of Calgary, Calgary, AlbertaT2N 1N4, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AlbertaT2N 4N1, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, AlbertaT2N 1N4, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AlbertaT2N 4N1, Canada
| | - Sarah Furtado
- Department of Clinical Neurosciences, University of Calgary, Calgary, AlbertaT2N 1N4, Canada
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2
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Ordás CM, Alonso-Frech F. The neural basis of somatosensory temporal discrimination threshold as a paradigm for time processing in the sub-second range: An updated review. Neurosci Biobehav Rev 2024; 156:105486. [PMID: 38040074 DOI: 10.1016/j.neubiorev.2023.105486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The temporal aspect of somesthesia is a feature of any somatosensory process and a pre-requisite for the elaboration of proper behavior. Time processing in the milliseconds range is crucial for most of behaviors in everyday life. The somatosensory temporal discrimination threshold (STDT) is the ability to perceive two successive stimuli as separate in time, and deals with time processing in this temporal range. Herein, we focus on the physiology of STDT, on a background of the anatomophysiology of somesthesia and the neurobiological substrates of timing. METHODS A review of the literature through PubMed & Cochrane databases until March 2023 was performed with inclusion and exclusion criteria following PRISMA recommendations. RESULTS 1151 abstracts were identified. 4 duplicate records were discarded before screening. 957 abstracts were excluded because of redundancy, less relevant content or not English-written. 4 were added after revision. Eventually, 194 articles were included. CONCLUSIONS STDT encoding relies on intracortical inhibitory S1 function and is modulated by the basal ganglia-thalamic-cortical interplay through circuits involving the nigrostriatal dopaminergic pathway and probably the superior colliculus.
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Affiliation(s)
- Carlos M Ordás
- Universidad Rey Juan Carlos, Móstoles, Madrid, Spain; Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - Fernando Alonso-Frech
- Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain
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Sattin D, Parma C, Lunetta C, Zulueta A, Lanzone J, Giani L, Vassallo M, Picozzi M, Parati EA. An Overview of the Body Schema and Body Image: Theoretical Models, Methodological Settings and Pitfalls for Rehabilitation of Persons with Neurological Disorders. Brain Sci 2023; 13:1410. [PMID: 37891779 PMCID: PMC10605253 DOI: 10.3390/brainsci13101410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Given the widespread debate on the definition of the terms "Body Schema" and "Body Image", this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role.
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Affiliation(s)
- Davide Sattin
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
| | - Chiara Parma
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department-ALS Unit, Via Camaldoli 64, 20138 Milan, Italy;
| | - Aida Zulueta
- Istituti Clinici Scientifici Maugeri IRCCS, Labion, Via Camaldoli 64, 20138 Milan, Italy;
| | - Jacopo Lanzone
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
| | - Luca Giani
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
| | - Marta Vassallo
- Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate, Via Camaldoli 64, 20138 Milan, Italy; (D.S.); (M.V.)
- Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, 21100 Varese, Italy;
| | - Mario Picozzi
- Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, 21100 Varese, Italy;
| | - Eugenio Agostino Parati
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Via Camaldoli 64, 20138 Milan, Italy; (J.L.); (L.G.); (E.A.P.)
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Hollý P, Duspivová T, Kemlink D, Ulmanová O, Rusz J, Krupička R, Jech R, Růžička E. Essential and dystonic head tremor: More similarities than differences. Parkinsonism Relat Disord 2023; 115:105850. [PMID: 37708603 DOI: 10.1016/j.parkreldis.2023.105850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Head tremor is a common symptom of essential tremor (ET) and cervical dystonia (CD). In clinical practice, it is often difficult to distinguish between these two conditions, especially in cases where head tremor predominates. OBJECTIVES To investigate which clinical and instrumental methods best differentiate ET and CD in patients with head tremor. METHODS 65 patients were included, of which 23 were diagnosed with ET and head tremor (HT+), 21 with ET without head tremor (HT-) and 21 with CD and dystonic head tremor. 22 healthy volunteers served as controls. All patients were examined using the rating scales for ET (TETRAS), cervical dystonia (TWSTRS), and ataxia (SARA). The Somatosensory Temporal Discrimination Threshold (STDT) was defined as the shortest interval in which an individual recognizes two tactile stimuli as temporally separated. RESULTS TETRAS and SARA scores were higher in the HT+ group compared with HT- and CD, with no significant difference between mild head tremor subscores in HT+ and CD. In most HT+ and CD patients, head tremor disappeared supine. The STDT values were significantly higher in the HT+ group compared with controls. CONCLUSION While TWSTRS contributed to assess dystonia severity, the scales of tremor and ataxia were not helpful in differentiating head tremor syndromes. The cessation of head tremor in the supine position could be related to the overall mild head tremor scores in both groups. Increased SARA scores and STDT values in HT+ patients suggest a possible role of cerebellar involvement and altered somatosensory timing that merit further verification.
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Affiliation(s)
- Petr Hollý
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic.
| | - Tereza Duspivová
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic; Department of Biomedical Informatics, Czech Technical University in Prague, Nám. Sítná 3105, 272 01, Kladno, Czech Republic.
| | - David Kemlink
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic.
| | - Olga Ulmanová
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic.
| | - Jan Rusz
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic; Department of Circuit Theory, Czech Technical University in Prague, Technická 2, 160 00, Prague 6, Czech Republic.
| | - Radim Krupička
- Department of Biomedical Informatics, Czech Technical University in Prague, Nám. Sítná 3105, 272 01, Kladno, Czech Republic.
| | - Robert Jech
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic.
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, Charles University, Kateřinská 30, 128 21, Prague 2, Czech Republic.
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5
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Young VN, Kidane J, Gochman GE, Bracken DJ, Ma Y, Rosen CA. Abnormal Laryngopharyngeal Sensation in Adductor Laryngeal Dystonia Compared to Healthy Controls. Laryngoscope 2023; 133:2271-2278. [PMID: 36271910 DOI: 10.1002/lary.30462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Laryngeal sensory abnormality has been implicated as a component of adductor laryngeal dystonia (AdLD). The study objective was to assess laryngopharyngeal sensation in AdLD utilizing a calibrated, tactile aesthesiometer to deliver differential stimuli to lateral pyriform sinus (LPS), aryepiglottic fold (AEF), and false vocal fold (FVF). METHODS Patients with known Botox-responsive AdLD underwent sensory testing using a previously-validated methodology involving calibrated tactile stimuli (6-0, 5-0, 4.5-0, 4-0 nylon monofilaments). Laryngeal adductor reflex (LAR) and participant-rated perceptual strength of stimulI were evaluated. Responses were compared to normative controls (n = 33). Two-samples, Mann-Whitney and Fisher exact tests compared mean strength ratings and LAR between AdLD and control groups. Mixed-effects logistic regression and linear models assessed association of filament size, stimulus site, age, sex, and LD status on LAR and perceptual strength rating respectively. RESULTS Thirteen AdLD patients (nine women, mean age 60+/-15 years) completed testing. Average LAR response rates were higher amongst all filament sizes in AdLD versus controls at LPS (56.3% vs. 35.7%) and AEF (96.1% vs. 70.2%) with comparable rates at FVF (90.2% vs. 91.7%). AdLD had 3.3 times the odds of observed LAR compared to controls (p = 0.005), but differences in subjective detection of stimuli, perceptual strength ratings, and cough/gag rates were insignificant on multivariate modeling (p > 0.05). CONCLUSIONS This is the first study to objectively assess laryngopharyngeal sensation in AdLD. Findings demonstrated increased laryngopharyngeal sensation in AdLD compared to controls. The identification of increased laryngeal hypersensitivity in these patients may improve understanding of AdLD pathophysiology and identify future targets for intervention. LEVEL OF EVIDENCE 2 Laryngoscope, 133:2271-2278, 2023.
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Affiliation(s)
- VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Joseph Kidane
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Grant E Gochman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - David J Bracken
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
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Manzo N, Ginatempo F, Belvisi D, Arcara G, Parrotta I, Leodori G, Deriu F, Celletti C, Camerota F, Conte A. Investigating the Effects of a Focal Muscle Vibration Protocol on Sensorimotor Integration in Healthy Subjects. Brain Sci 2023; 13:brainsci13040664. [PMID: 37190629 DOI: 10.3390/brainsci13040664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Background: The ability to perceive two tactile stimuli as asynchronous can be measured using the somatosensory temporal discrimination threshold (STDT). In healthy humans, the execution of a voluntary movement determines an increase in STDT values, while the integration of STDT and movement execution is abnormal in patients with basal ganglia disorders. Sensorimotor integration can be modulated using focal muscle vibration (fMV), a neurophysiological approach that selectively activates proprioceptive afferents from the vibrated muscle. Method: In this study, we investigated whether fMV was able to modulate STDT or STDT-movement integration in healthy subjects by measuring them before, during and after fMV applied over the first dorsalis interosseous, abductor pollicis brevis and flexor radialis carpi muscles. Results: The results showed that fMV modulated STDT-movement integration only when applied over the first dorsalis interosseous, namely, the muscle performing the motor task involved in STDT-movement integration. These changes occurred during and up to 10 min after fMV. Differently, fMV did not influence STDT at rest. We suggest that that fMV interferes with the STDT-movement task processing, possibly disrupting the physiological processing of sensory information. Conclusions: This study showed that FMV is able to modulate STDT-movement integration when applied over the muscle involved in the motor task. This result provides further information on the mechanisms underlying fMV, and has potential future implications in basal ganglia disorders characterized by altered sensorimotor integration.
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Affiliation(s)
- Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Ilaria Parrotta
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
- Movement Contral and Neuroplasticity Research Group, Tervuursevest 101, 3001 Leuven, Belgium
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
- Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, 07100 Sassari, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
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Söke F, Ataoğlu NEE, Öztekin MF, Koçer B, Karakoç S, Gülşen Ç, Çomoğlu SS, Bora HA. Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turk J Med Sci 2023; 53:405-412. [PMID: 36945943 PMCID: PMC10388090 DOI: 10.55730/1300-0144.5597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Impaired trunk control is common in neurological disorders; however, trunk control has not been examined in patients with cervical dystonia (CD). Therefore, the primary aim was to compare trunk control between patients with CD and healthy people. The secondary aim was to investigate the relationship between trunk control and balance, functional mobility, and disease severity in patients with CD. METHODS ]This cross-sectional study included 32 patients with CD and 32 healthy people. Trunk control was compared using the trunk impairment scale (TIS) that consists of three subscales: static sitting balance, dynamic sitting balance, and trunk coordination between two groups. Balance was assessed using Berg Balance Scale, four square step test, and one-leg stance test. The Timed Up and Go Test was measured to determine functional mobility. Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate disease severity.]></AbstractText> <AbstractText Label="RESULTS"><![CDATA[ Patients with CD demonstrated worse performance on the TIS-total with TIS-dynamic sitting subscale and TIS-trunk coordination subscale (p < 0.001, p < 0.001, and p < 0.001), except for TIS-static sitting subscale (p = 0.078) compared to healthy people. TIS-total scores had moderate to strong correlations with balance, functional mobility, and disease severity (range r between 0.786 and 0.536, p < 0.05 for all). There was no correlation between TIS-total scores and disease severity (p = 0.102). DISCUSSION Patients with CD had impaired trunk control, especially in dynamic sitting balance and trunk coordination. Impaired trunk control was also associated with balance and functional mobility but not disease severity. These findings suggest that trunk control deficits should receive attention in the assessment and treatment of patients with CD.
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Affiliation(s)
- Fatih Söke
- Department of Physiotherapy and Rehabilitation, Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | | | - Mehmet Fevzi Öztekin
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bilge Koçer
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoç
- Department of Physiotherapy and Rehabilitation, Gülhane Institute of Health Science, University of Health Sciences, Ankara, Turkey
| | - Çağrı Gülşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Selim Selçuk Çomoğlu
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hatice Ayşe Bora
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Pham MV, Saito K, Miyaguchi S, Watanabe H, Ikarashi H, Nagasaka K, Yokota H, Kojima S, Inukai Y, Otsuru N, Onishi H. Changes in excitability and GABAergic neuronal activity of the primary somatosensory cortex after motor learning. Front Neurosci 2022; 16:794173. [PMID: 36203802 PMCID: PMC9530600 DOI: 10.3389/fnins.2022.794173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction It is widely known that motor learning changes the excitability of the primary motor cortex. More recently, it has been shown that the primary somatosensory cortex (S1) also plays an important role in motor learning, but the details have not been fully examined. Therefore, we investigated how motor skill training affects somatosensory evoked potential (SEP) in 30 neurologically healthy subjects. Methods SEP N20/P25_component and N20/P25 SEP paired-pulse depression (SEP-PPD) were assessed before and immediately after complex or simple visuomotor tasks. Results Motor learning was induced more efficiently by the complex visuomotor task than by the simple visuomotor task. Both the N20/P25 SEP amplitude and N20/P25 SEP-PPD increased significantly immediately after the complex visuomotor task, but not after the simple visuomotor task. Furthermore, the altered N20/P25 SEP amplitude was associated with an increase in motor learning efficiency. Conclusion These results suggest that motor learning modulated primary somatosensory cortex excitability.
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Affiliation(s)
- Manh Van Pham
- Department of Physical Therapy, Hai Duong Medical Technical University, Hai Duong, Vietnam
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
- *Correspondence: Kei Saito,
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiraku Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Graduate School, Niigata University of Health and Welfare, Niigata, Japan
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Hitomi Ikarashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Graduate School, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Yasuto Inukai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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9
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Sasaki R, Watanabe H, Onishi H. Therapeutic benefits of noninvasive somatosensory cortex stimulation on cortical plasticity and somatosensory function: a systematic review. Eur J Neurosci 2022; 56:4669-4698. [PMID: 35804487 DOI: 10.1111/ejn.15767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
Optimal limb coordination requires efficient transmission of somatosensory information to the sensorimotor cortex. The primary somatosensory cortex (S1) is frequently damaged by stroke, resulting in both somatosensory and motor impairments. Noninvasive brain stimulation (NIBS) to the primary motor cortex is thought to induce neural plasticity that facilitates neurorehabilitation. Several studies have also examined if NIBS to the S1 can enhance somatosensory processing as assessed by somatosensory-evoked potentials (SEPs) and improve behavioral task performance, but it remains uncertain if NIBS can reliably modulate S1 plasticity or even whether SEPs can reflect this plasticity. This systematic review revealed that NIBS has relatively minor effects on SEPs or somatosensory task performance, but larger early SEP changes after NIBS can still predict improved performance. Similarly, decreased paired-pulse inhibition in S1 post-NIBS is associated with improved somatosensory performance. However, several studies still debate the role of inhibitory function in somatosensory performance after NIBS in terms of the direction of the change (that, disinhibition or inhibition). Altogether, early SEP and paired-pulse inhibition (particularly inter-stimulus intervals of 30-100 ms) may become useful biomarkers for somatosensory deficits, but improved NIBS protocols are required for therapeutic applications.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, Australia
| | - Hiraku Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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10
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Aïssa HB, Sala RW, Georgescu Margarint EL, Frontera JL, Varani AP, Menardy F, Pelosi A, Hervé D, Léna C, Popa D. Functional abnormalities in the cerebello-thalamic pathways in a mouse model of DYT25 dystonia. eLife 2022; 11:79135. [PMID: 35699413 PMCID: PMC9197392 DOI: 10.7554/elife.79135] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022] Open
Abstract
Dystonia is often associated with functional alterations in the cerebello-thalamic pathways, which have been proposed to contribute to the disorder by propagating pathological firing patterns to the forebrain. Here, we examined the function of the cerebello-thalamic pathways in a model of DYT25 dystonia. DYT25 (Gnal+/−) mice carry a heterozygous knockout mutation of the Gnal gene, which notably disrupts striatal function, and systemic or striatal administration of oxotremorine to these mice triggers dystonic symptoms. Our results reveal an increased cerebello-thalamic excitability in the presymptomatic state. Following the first dystonic episode, Gnal+/- mice in the asymptomatic state exhibit a further increase of the cerebello-thalamo-cortical excitability, which is maintained after θ-burst stimulations of the cerebellum. When administered in the symptomatic state induced by a cholinergic activation, these stimulations decreased the cerebello-thalamic excitability and reduced dystonic symptoms. In agreement with dystonia being a multiregional circuit disorder, our results suggest that the increased cerebello-thalamic excitability constitutes an early endophenotype, and that the cerebellum is a gateway for corrective therapies via the depression of cerebello-thalamic pathways.
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Affiliation(s)
- Hind Baba Aïssa
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Romain W Sala
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Elena Laura Georgescu Margarint
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Jimena Laura Frontera
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Andrés Pablo Varani
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Fabien Menardy
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Assunta Pelosi
- Inserm UMR-S 1270, Paris, France.,Sorbonne Université, Sciences and Technology Faculty, Paris, France.,Institut du Fer à Moulin, Paris, France
| | - Denis Hervé
- Inserm UMR-S 1270, Paris, France.,Sorbonne Université, Sciences and Technology Faculty, Paris, France.,Institut du Fer à Moulin, Paris, France
| | - Clément Léna
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Daniela Popa
- Neurophysiology of Brain Circuits Team, Institut de biologie de l'Ecole normale supérieure (IBENS), Ecole normale supérieure, CNRS, INSERM, PSL Research University, Paris, France
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11
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Bologna M, Valls-Solè J, Kamble N, Pal PK, Conte A, Guerra A, Belvisi D, Berardelli A. Dystonia, chorea, hemiballismus and other dyskinesias. Clin Neurophysiol 2022; 140:110-125. [PMID: 35785630 DOI: 10.1016/j.clinph.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
Hyperkinesias are heterogeneous involuntary movements that significantly differ in terms of clinical and semeiological manifestations, including rhythm, regularity, speed, duration, and other factors that determine their appearance or suppression. Hyperkinesias are due to complex, variable, and largely undefined pathophysiological mechanisms that may involve different brain areas. In this chapter, we specifically focus on dystonia, chorea and hemiballismus, and other dyskinesias, specifically, levodopa-induced, tardive, and cranial dyskinesia. We address the role of neurophysiological studies aimed at explaining the pathophysiology of these conditions. We mainly refer to human studies using surface and invasive in-depth recordings, as well as spinal, brainstem, and transcortical reflexology and non-invasive brain stimulation techniques. We discuss the extent to which the neurophysiological abnormalities observed in hyperkinesias may be explained by pathophysiological models. We highlight the most relevant issues that deserve future research efforts. The potential role of neurophysiological assessment in the clinical context of hyperkinesia is also discussed.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy
| | - Josep Valls-Solè
- Institut d'Investigació Biomèdica August Pi I Sunyer, Villarroel, 170, Barcelona, Spain
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy.
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12
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Guerra A, Bologna M. Low-Intensity Transcranial Ultrasound Stimulation: Mechanisms of Action and Rationale for Future Applications in Movement Disorders. Brain Sci 2022; 12:brainsci12050611. [PMID: 35624998 PMCID: PMC9139935 DOI: 10.3390/brainsci12050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
Low-intensity transcranial ultrasound stimulation (TUS) is a novel non-invasive brain stimulation technique that uses acoustic energy to induce changes in neuronal activity. However, although low-intensity TUS is a promising neuromodulation tool, it has been poorly studied as compared to other methods, i.e., transcranial magnetic and electrical stimulation. In this article, we first focus on experimental studies in animals and humans aimed at explaining its mechanisms of action. We then highlight possible applications of TUS in movement disorders, particularly in patients with parkinsonism, dystonia, and tremor. Finally, we highlight the knowledge gaps and possible limitations that currently limit potential TUS applications in movement disorders. Clarifying the potential role of TUS in movement disorders may further promote studies with therapeutic perspectives in this field.
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Affiliation(s)
| | - Matteo Bologna
- IRCCS Neuromed, 86077 Pozzilli, Italy;
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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13
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Exploring the connections between basal ganglia and cortex revealed by transcranial magnetic stimulation, evoked potential and deep brain stimulation in dystonia. Eur J Paediatr Neurol 2022; 36:69-77. [PMID: 34922163 DOI: 10.1016/j.ejpn.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/30/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2022]
Abstract
We review the findings for motor cortical excitability, plasticity and evoked potentials in dystonia. Plasticity can be induced and assessed in cortical areas by non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and the invasive technique of deep brain stimulation (DBS), which allows access to deep brain structures. Single-pulse TMS measures have been widely studied in dystonia and consistently showed reduced silent period duration. Paired pulse TMS measures showed reduced short and long interval intracortical inhibition, interhemispheric inhibition, long-latency afferent inhibition and increased intracortical facilitation in dystonia. Repetitive transcranial magnetic stimulation (rTMS) of the premotor cortex improved handwriting with prolongation of the silent period in focal hand dystonia patients. Continuous theta-burst stimulation (cTBS) of the cerebellum or cTBS of the dorsal premotor cortex improved dystonia in some studies. Plasticity induction protocols in dystonia demonstrated excessive motor cortical plasticity with the reduction in cortico-motor topographic specificity. Bilateral DBS of the globus pallidus internus (GPi) improves dystonia, associated pain and functional disability. Local field potentials recordings in dystonia patients suggested that there is increased power in the low-frequency band (4-12 Hz) in the GPi. Cortical evoked potentials at peak latencies of 10 and 25 ms can be recorded with GPi stimulation in dystonia. Plasticity induction protocols based on the principles of spike timing dependent plasticity that involved repeated pairing of GPi-DBS and motor cortical TMS at latencies of cortical evoked potentials induced motor cortical plasticity. These studies expanded our knowledge of the pathophysiology of dystonia and how cortical excitability and plasticity are altered with different treatments such as DBS.
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14
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Celletti C, Ferrazzano G, Belvisi D, Ferrario C, Tarabini M, Baione V, Fabbrini G, Conte A, Galli M, Camerota F. Instrumental Timed Up and Go test discloses abnormalities in patients with Cervical Dystonia. Clin Biomech (Bristol, Avon) 2021; 90:105493. [PMID: 34715549 DOI: 10.1016/j.clinbiomech.2021.105493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/11/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
Background Cervical dystonia is a movement disorder characterized by involuntary and sustained contraction of the neck muscles that determines abnormal posture. The aim of this study was to investigate whether dystonic posture in patients with cervical dystonia affects walking and causes postural changes. Methods Patients with cervical dystonia and a group of age-matched healthy controls underwent an instrumental evaluation of the Timed Up and Go Test. Findings All the spatio-temporal parameters of the sub-phases of the Timed up and go test had a significantly higher duration in cervical dystonia patients compared to the control group while no differences in flection and extension angular amplitudes were observed. Indeed, we found that Cervical Dystonia patients had abnormalities in turning, as well as in standing-up and sitting-down from a chair during the Timed up and go test than healthy controls. Interpretation Impairment in postural control in cervical dystonia patients during walking and postural changes prompts to develop rehabilitation strategies to improve postural stability and reduce the risk of fall in these patients.
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Affiliation(s)
- C Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Italy.
| | - G Ferrazzano
- Department of Human Neurosciences, Sapienza, University of Rome, Italy
| | - D Belvisi
- Department of Human Neurosciences, Sapienza, University of Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - C Ferrario
- Department of Mechanical Engineering, Politecnico di Milano, 20124 Milan, Italy; DEIB, Dept of Electronics, Information and Bioengineering, Politecnico di Milano, Italy
| | - M Tarabini
- Department of Mechanical Engineering, Politecnico di Milano, 20124 Milan, Italy
| | - V Baione
- Department of Human Neurosciences, Sapienza, University of Rome, Italy
| | - G Fabbrini
- Department of Human Neurosciences, Sapienza, University of Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - A Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - M Galli
- DEIB, Dept of Electronics, Information and Bioengineering, Politecnico di Milano, Italy
| | - F Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Italy
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15
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Manzo N, Tocco P, Ginatempo F, Bertolasi L, Rocchi L. Brainstem Reflexes in Idiopathic Cervical Dystonia: Does Medullary Dysfunction Play a Role? Mov Disord Clin Pract 2021; 8:377-384. [PMID: 33816666 PMCID: PMC8015899 DOI: 10.1002/mdc3.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/08/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Neurophysiological markers in dystonia have so far not been sistematically applied in clinical practice due to limited reproducibility of results and low correlations with clinical findings. Exceptions might be represented by the blink reflex (BR), including its recovery cycle (BRRC) and the trigemino‐cervical reflex (TCR) which, compared to other neurophysiological methods, have shown more consistent alterations in cervical dystonia (CD). However, a comparison between the two techniques, and their possible correlation with disease symptoms, have not been thoroughly investigated. Objectives To assess the role of BR, BRCC and TCR in the pathophysiology of idiopathic cervical dystonia. Methods Fourteen patients and 14 age‐matched healthy controls (HC) were recruited. Neurophysiological outcome measures included latency of R1 and R2 components of the BR, R2 amplitude, BRRC, latency and amplitude of P19/N31 complex of TCR. Clinical and demographic features of patients were also collected, including age at disease onset, disease duration, presence of tremor, sensory trick and pain. The Toronto Western Spasmodic Torticollis Rating Scale was used to characterize dystonia. Results Compared to HC, CD patients showed increased latency of the BR R2 and decreased suppression of the BRRC. They also showed increased latency of the P19 and decreased amplitude of P19/N31 complex of TCR. The latency of P19 component of TCR was positively correlated with disease duration. Conclusions We propose that the increased latency of R2 and P19 observed here might be reflective of brainstem dysfunction, mediated either by local interneuronal excitability changes or by subtle structural damage.
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Affiliation(s)
| | - Pierluigi Tocco
- Department of Neuroscience, Biomedicine and Movement Sciences University of Verona Verona Italy
| | | | - Laura Bertolasi
- Department of Neuroscience, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movements Neurosciences, UCL Queen Square Institute of Neurology University College London London United Kingdom
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16
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Latorre A, Rocchi L, Batla A, Berardelli A, Rothwell JC, Bhatia KP. The Signature of Primary Writing Tremor Is Dystonic. Mov Disord 2021; 36:1715-1720. [PMID: 33786886 DOI: 10.1002/mds.28579] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 01/28/2021] [Accepted: 02/16/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It has been debated for decades whether primary writing tremor is a form of dystonic tremor, a variant of essential tremor, or a separate entity. We wished to test the hypothesis that primary writing tremor and dystonia share a common pathophysiology. OBJECTIVES The objective of the present study was to investigate the pathophysiological hallmarks of dystonia in patients affected by primary writing tremor. METHODS Ten patients with idiopathic dystonic tremor syndrome, 7 with primary writing tremor, 10 with essential tremor, and 10 healthy subjects were recruited. They underwent eyeblink classic conditioning, blink recovery cycle, and transcranial magnetic stimulation assessment, including motor-evoked potentials and short- and long-interval intracortical inhibition at baseline. Transcranial magnetic stimulation measures were also recorded after paired-associative plasticity protocol. RESULTS Primary writing tremor and dystonic tremor syndrome had a similar pattern of electrophysiological abnormalities, consisting of reduced eyeblink classic conditioning learning, reduced blink recovery cycle inhibition, and a lack of effect of paired-associative plasticity on long-interval intracortical inhibition. The latter 2 differ from those obtained in essential tremor and healthy subjects. Although not significant, slightly reduced short-interval intracortical inhibition and a larger effect of paired-associative plasticity in primary writing tremor and dystonic tremor syndrome, compared with essential tremor and healthy subjects, was observed. CONCLUSIONS Our initial hypothesis of a common pathophysiology between dystonia and primary writing tremor has been confirmed. Primary writing tremor might be considered a form of dystonic tremor. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London, London, UK.,Department of Human Neurosciences, University of Rome "Sapienza,", Rome, Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, 09124, Cagliari, Italy
| | - Amit Batla
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London, London, UK
| | - Alfredo Berardelli
- Department of Human Neurosciences, University of Rome "Sapienza,", Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London, London, UK
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London, London, UK
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17
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Kaňovský P, Rosales R, Otruba P, Nevrlý M, Hvizdošová L, Opavský R, Kaiserová M, Hok P, Menšíková K, Hluštík P, Bareš M. Contemporary clinical neurophysiology applications in dystonia. J Neural Transm (Vienna) 2021; 128:509-519. [PMID: 33591454 DOI: 10.1007/s00702-021-02310-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 12/25/2022]
Abstract
The complex phenomenological understanding of dystonia has transcended from the clinics to genetics, imaging and neurophysiology. One way in which electrophysiology will impact into the clinics are cases wherein a dystonic clinical presentation may not be typical or a "forme fruste" of the disorder. Indeed, the physiological imprints of dystonia are present regardless of its clinical manifestation. Underpinnings in the understanding of dystonia span from the peripheral, segmental and suprasegmental levels to the cortex, and various electrophysiological tests have been applied in the course of time to elucidate the origin of dystonia pathophysiology. While loss of inhibition remains to be the key finding in this regard, intricacies and variabilities exist, thus leading to a notion that perhaps dystonia should best be gleaned as network disorder. Interestingly, the complex process has now spanned towards the understanding in terms of networks related to the cerebellar circuitry and the neuroplasticity. What is evolving towards a better and cohesive view will be neurophysiology attributes combined with structural dynamic imaging. Such a sound approach will significantly lead to better therapeutic modalities in the future.
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Affiliation(s)
- Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
| | - Raymond Rosales
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.,Department of Neurology and Psychiatry, The Neuroscience Institute, University of Santo Tomás Hospital, Manila, Philippines
| | - Pavel Otruba
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Martin Nevrlý
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Lenka Hvizdošová
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Robert Opavský
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Michaela Kaiserová
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Kateřina Menšíková
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Petr Hluštík
- Department of Neurology, Faculty of Medicine and Dentistry, University Hospital, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Martin Bareš
- 1st Department of Neurology, Masaryk University Medical School and St. Anne University Hospital, Brno, Czech Republic
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18
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Latorre A, Cocco A, Bhatia KP, Erro R, Antelmi E, Conte A, Rothwell JC, Rocchi L. Defective Somatosensory Inhibition and Plasticity Are Not Required to Develop Dystonia. Mov Disord 2020; 36:1015-1021. [PMID: 33332649 DOI: 10.1002/mds.28427] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/21/2020] [Accepted: 11/18/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Dystonia may have different neuroanatomical substrates and pathophysiology. This is supported by studies on the motor system showing, for instance, that plasticity is abnormal in idiopathic dystonia, but not in dystonia secondary to basal ganglia lesions. OBJECTIVE The aim of this study was to test whether somatosensory inhibition and plasticity abnormalities reported in patients with idiopathic dystonia also occur in patients with dystonia caused by basal ganglia damage. METHODS Ten patients with acquired dystonia as a result of basal ganglia lesions and 12 healthy control subjects were recruited. They underwent electrophysiological testing at baseline and after a single 45-minute session of high-frequency repetitive somatosensory stimulation. Electrophysiological testing consisted of somatosensory temporal discrimination, somatosensory-evoked potentials (including measurement of early and late high-frequency oscillations and the spatial inhibition ratio of N20/25 and P14 components), the recovery cycle of paired-pulse somatosensory-evoked potentials, and primary motor cortex short-interval intracortical inhibition. RESULTS Unlike previous reports of patients with idiopathic dystonia, patients with acquired dystonia did not differ from healthy control subjects in any of the electrophysiological measures either before or after high-frequency repetitive somatosensory stimulation, except for short-interval intracortical inhibition, which was reduced at baseline in patients compared to control subjects. CONCLUSIONS The data show that reduced somatosensory inhibition and enhanced cortical plasticity are not required for the clinical expression of dystonia, and that the abnormalities reported in idiopathic dystonia are not necessarily linked to basal ganglia damage. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Antoniangela Cocco
- Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Neuroscience, Catholic University, Milan, Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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19
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Erro R, Antelmi E, Bhatia KP, Latorre A, Tinazzi M, Berardelli A, Rothwell JC, Rocchi L. Reversal of Temporal Discrimination in Cervical Dystonia after Low-Frequency Sensory Stimulation. Mov Disord 2020; 36:761-766. [PMID: 33159823 DOI: 10.1002/mds.28369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/26/2020] [Accepted: 10/12/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Somatosensory temporal discrimination is abnormal in dystonia and reflects reduced somatosensory inhibition. In healthy individuals, both the latter are enhanced by high-frequency repetitive somatosensory stimulation, whereas opposite effects are observed in patients with cervical dystonia. OBJECTIVES We tested whether low-frequency repetitive sensory stimulation, which in healthy individuals worsens discrimination, might have the opposite effect in patients with cervical dystonia at the physiological level and, in turn, improve their perceptual performance. METHODS Somatosensory temporal discrimination and several electrophysiological measures of sensorimotor inhibition were collected before and after 45 minutes of low-frequency repetitive sensory stimulation. RESULTS As predicted, and opposite to what happened in controls, low-frequency repetitive sensory stimulation in patients enhanced sensorimotor inhibition and normalized somatosensory temporal discrimination. CONCLUSIONS Patients with cervical dystonia have an abnormal response to repetitive sensory stimulation, which we hypothesize is attributed to abnormally sensitive homeostatic mechanisms of inhibitory circuitry in both sensory and motor systems. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy
| | - Elena Antelmi
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
| | - Michele Tinazzi
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
- IRCCS Neuromed Institute, Pozzilli, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
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20
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Tarrano C, Lamy JC, Delorme C, McGovern EM, Atkinson-Clement C, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol JC, Pedespan JM, Krystkoviak P, Houeto JL, Degardin A, Defebvre L, Apartis E, Vidailhet M, Roze E, Worbe Y. Tactile Temporal Discrimination Is Impaired in Myoclonus-Dystonia. Mov Disord 2020; 35:2356-2357. [PMID: 32960985 DOI: 10.1002/mds.28253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Clément Tarrano
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Jean-Charles Lamy
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France
| | - Cécile Delorme
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Eavan M McGovern
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France.,Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland
| | - Cyril Atkinson-Clement
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France
| | - Vanessa Brochard
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Centre d'Investigation Clinique 1422, INSERM/APHP, Paris, France
| | - Stéphane Thobois
- University of Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Bron, France
| | - Christine Tranchant
- Hopital de Hautepierre, Neurologie, Strasbourg, France.,Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - David Grabli
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Bertrand Degos
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Hôpital Avicennes, Bobigny, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | | | - Pierre Krystkoviak
- Department of Neurology, Amiens University Medical Center, Amiens, France
| | - Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Poitiers, France
| | - Adrian Degardin
- Department of Neurology, Centre hospitalier de Tourcoing, Tourcoing, France
| | - Luc Defebvre
- University Lille, CHU Lille, INSERM, U1172 - Degenerative & Vascular Cognitive Disorders, Lille, France.,Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND), Lille, France
| | - Emmanuelle Apartis
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Departement of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Emmanuel Roze
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Yulia Worbe
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Departement of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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21
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Hess CW, Gatto B, Chung JW, Ho RLM, Wang WE, Wagle Shukla A, Vaillancourt DE. Cortical Oscillations in Cervical Dystonia and Dystonic Tremor. Cereb Cortex Commun 2020; 1:tgaa048. [PMID: 32984818 PMCID: PMC7503385 DOI: 10.1093/texcom/tgaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 11/14/2022] Open
Abstract
Dystonia involves sustained or repetitive muscle contractions, affects different skeletal muscles, and may be associated with tremor. Few studies have investigated if cortical pathophysiology is impaired even when dystonic muscles are not directly engaged and during the presence of dystonic tremor (DT). Here, we recorded high-density electroencephalography and time-locked behavioral data in 2 cohorts of patients and controls during the performance of head movements, upper limb movements, and grip force. Patients with cervical dystonia had reduced movement-related desynchronization in the alpha and beta bands in the bilateral sensorimotor cortex during head turning movements, produced by dystonic muscles. Reduced desynchronization in the upper beta band in the ipsilateral motor and bilateral sensorimotor cortex was found during upper limb planar movements, produced by non-dystonic muscles. In a precision grip task, patients with DT had reduced movement-related desynchronization in the alpha and beta bands in the bilateral sensorimotor cortex. We observed a general pattern of abnormal sensorimotor cortical desynchronization that was present across the head and upper limb motor tasks, in patients with and without DT when compared with controls. Our findings suggest that abnormal cortical desynchronization is a general feature of dystonia that should be a target of pharmacological and other therapeutic interventions.
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Affiliation(s)
- Christopher W Hess
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, FL 32611, USA
| | - Bryan Gatto
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Jae Woo Chung
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Rachel L M Ho
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Wei-En Wang
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Aparna Wagle Shukla
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, FL 32611, USA
| | - David E Vaillancourt
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, FL 32611, USA.,Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
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22
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Affective and cognitive theory of mind in patients with cervical dystonia with and without tremor. J Neural Transm (Vienna) 2020; 128:199-206. [PMID: 32770275 DOI: 10.1007/s00702-020-02237-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/30/2020] [Indexed: 12/25/2022]
Abstract
Theory of mind (ToM) refers to an individual's ability to attribute mental states to predict and explain another person's behavior. It has been shown that patients with cervical dystonia (CD) present impaired ToM ability supporting the idea that CD is a network disorder. An emerging hypothesis is that different phenotypes of CD reflect distinct key nodes in the malfunctioning cerebral network. The aim of the present study was to investigate whether the presence of tremor as additional phenotypic feature of CD influences the ability to attribute a cognitive or emotional state to another person. We enrolled 35 patients with CD, 21 with tremor (CD-T) and 14 without tremor (CD-NT) and 47 age-matched healthy subjects (HS). The Emotion Attribution Task (EAT) was adopted to assess the affective ToM ability while the Advanced Test (AT) was used to investigate the cognitive ToM ability. Results showed that CD patients' performance was worse than HS in recognizing the emotional feelings expressed in the EAT situations, with no difference between CD-T and CD-NT. Regarding cognitive ToM, both CD-T and CD-NT performed worse than HS in the AT task. However, it also emerged that CD-T were more impaired in AT task than CD-NT. Our results indicate that both affective and cognitive aspects of ToM are impaired in CD and that cognitive ToM is more impaired in patients presenting tremor respect to those without. These findings support the hypothesis that the cerebral network responsible of motor and non-motor impairments is more widespread in CD-T than CD-NT.
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23
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Latorre A, Rocchi L, Bhatia KP. Delineating the electrophysiological signature of dystonia. Exp Brain Res 2020; 238:1685-1692. [PMID: 32712678 DOI: 10.1007/s00221-020-05863-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Over the last 30 years, the concept of dystonia has dramatically changed, from being considered a motor neurosis, to a pure basal ganglia disorder, to finally reach the definition of a network disorder involving the basal ganglia, cerebellum, thalamus and sensorimotor cortex. This progress has been possible due to the collaboration between clinicians and scientists, and the development of increasingly sophisticated electrophysiological techniques able to non-invasively investigate pathophysiological mechanisms in humans. This review is a chronological excursus of the electrophysiological studies that laid the foundation for the understanding of the pathophysiology of dystonia and delineated its electrophysiological signatures. Evidence for neurophysiological abnormalities is grouped according to the neural system involved, and a unifying theory, bringing together all the hypothesis and evidence provided to date, is proposed at the end.
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Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK.
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24
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Neurophysiological insights in dystonia and its response to deep brain stimulation treatment. Exp Brain Res 2020; 238:1645-1657. [PMID: 32638036 PMCID: PMC7413898 DOI: 10.1007/s00221-020-05833-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/11/2020] [Indexed: 01/29/2023]
Abstract
Dystonia is a movement disorder characterised by involuntary muscle contractions resulting in abnormal movements, postures and tremor. The pathophysiology of dystonia is not fully understood but loss of neuronal inhibition, excessive sensorimotor plasticity and defective sensory processing are thought to contribute to network dysfunction underlying the disorder. Neurophysiology studies have been important in furthering our understanding of dystonia and have provided insights into the mechanism of effective dystonia treatment with pallidal deep brain stimulation. In this article we review neurophysiology studies in dystonia and its treatment with Deep Brain Stimulation, including Transcranial magnetic stimulation studies, studies of reflexes and sensory processing, and oscillatory activity recordings including local field potentials, micro-recordings, EEG and evoked potentials.
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25
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Does the network model fits neurophysiological abnormalities in blepharospasm? Neurol Sci 2020; 41:2067-2079. [DOI: 10.1007/s10072-020-04347-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 03/16/2020] [Indexed: 10/24/2022]
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26
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Conte A, Defazio G, Mascia M, Belvisi D, Pantano P, Berardelli A. Advances in the pathophysiology of adult-onset focal dystonias: recent neurophysiological and neuroimaging evidence. F1000Res 2020; 9. [PMID: 32047617 PMCID: PMC6993830 DOI: 10.12688/f1000research.21029.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 12/28/2022] Open
Abstract
Focal dystonia is a movement disorder characterized by involuntary muscle contractions that determine abnormal postures. The traditional hypothesis that the pathophysiology of focal dystonia entails a single structural dysfunction (i.e. basal ganglia) has recently come under scrutiny. The proposed network disorder model implies that focal dystonias arise from aberrant communication between various brain areas. Based on findings from animal studies, the role of the cerebellum has attracted increased interest in the last few years. Moreover, it has been increasingly reported that focal dystonias also include nonmotor disturbances, including sensory processing abnormalities, which have begun to attract attention. Current evidence from neurophysiological and neuroimaging investigations suggests that cerebellar involvement in the network and mechanisms underlying sensory abnormalities may have a role in determining the clinical heterogeneity of focal dystonias.
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Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy
| | - Marcello Mascia
- Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy
| | | | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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27
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Avanzino L, Cherif A, Crisafulli O, Carbone F, Zenzeri J, Morasso P, Abbruzzese G, Pelosin E, Konczak J. Tactile and proprioceptive dysfunction differentiates cervical dystonia with and without tremor. Neurology 2020; 94:e639-e650. [DOI: 10.1212/wnl.0000000000008916] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
ObjectiveTo determine whether different phenotypes of cervical dystonia (CD) express different types and levels of somatosensory impairment.MethodsWe assessed somatosensory function in patients with CD with and without tremor (n = 12 each) and in healthy age-matched controls (n = 22) by measuring tactile temporal discrimination thresholds of the nondystonic forearm and proprioceptive acuity in both the dystonic (head/neck) and nondystonic body segments (forearm/hand) using a joint position‐matching task. The head or the wrist was passively displaced along different axes to distinct joint positions by the experimenter or through a robotic exoskeleton. Participants actively reproduced the experienced joint position, and the absolute joint position‐matching error between the target and the reproduced positions served as a marker of proprioceptive acuity.ResultsTactile temporal discrimination thresholds were significantly elevated in both CD subgroups compared to controls. Proprioceptive acuity of both the dystonic and nondystonic body segments was elevated in patients with CD and tremor with respect to both healthy controls and patients with CD without tremor. That is, tactile abnormalities were a shared dysfunction of both CD phenotypes, while proprioceptive dysfunction was observed in patients with CD with tremor.ConclusionsOur findings suggest that the pathophysiology in CD can be characterized by 2 abnormal neural processes: a dysfunctional somatosensory gating mechanism involving the basal ganglia that triggers involuntary muscle spasms and abnormal processing of proprioceptive information within a defective corticocerebellar loop, likely affecting the feedback and feedforward control of head positioning. This dysfunction is expressed mainly in CD with tremor.
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28
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Sarasso E, Agosta F, Piramide N, Bianchi F, Butera C, Gatti R, Amadio S, Del Carro U, Filippi M. Sensory trick phenomenon in cervical dystonia: a functional MRI study. J Neurol 2020; 267:1103-1115. [DOI: 10.1007/s00415-019-09683-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 12/11/2022]
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29
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Gövert F, Becktepe J, Balint B, Rocchi L, Brugger F, Garrido A, Walter T, Hannah R, Rothwell J, Elble R, Deuschl G, Bhatia K. Temporal discrimination is altered in patients with isolated asymmetric and jerky upper limb tremor. Mov Disord 2019; 35:306-315. [PMID: 31724777 DOI: 10.1002/mds.27880] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/01/2019] [Accepted: 09/16/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Unilateral or very asymmetric upper limb tremors with a jerky appearance are poorly investigated. Their clinical classification is an unsolved problem because their classification as essential tremor versus dystonic tremor is uncertain. To avoid misclassification as essential tremor or premature classification as dystonic tremor, the term indeterminate tremor was suggested. OBJECTIVES The aim of this study was to characterize this tremor subgroup electrophysiologically and evaluate whether diagnostically meaningful electrophysiological differences exist compared to patients with essential tremor and dystonic tremor. METHODS We enrolled 29 healthy subjects and 64 patients with tremor: 26 with dystonic tremor, 23 with essential tremor, and 15 patients with upper limb tremor resembling essential tremor but was unusually asymmetric and jerky (indeterminate tremor). We investigated the somatosensory temporal discrimination threshold, the short-interval intracortical inhibition, and the cortical plasticity by paired associative stimulation. RESULTS Somatosensory temporal discrimination threshold was significantly increased in patients with dystonic tremor and indeterminate tremor, but it was normal in the essential tremor patients and healthy controls. Significant differences in short-interval intracortical inhibition and paired associative stimulation were not found among the three patient groups and controls. CONCLUSION These results indicate that indeterminate tremor, as defined in this study, shares electrophysiological similarities with dystonic tremor rather than essential tremor. Therefore, we propose that indeterminate tremor should be considered as a separate clinical entity from essential tremor and that it might be dystonic in nature. Somatosensory temporal discrimination appears to be a useful tool in tremor classification. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Felix Gövert
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.,Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jos Becktepe
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Florian Brugger
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom.,Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Alicia Garrido
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom.,Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut d'investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Tim Walter
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Ricci Hannah
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - John Rothwell
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rodger Elble
- Department of Neurology, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Kailash Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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30
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Naro A, Billeri L, Portaro S, Bramanti P, Calabrò RS. Lasting Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation in Writer's Cramp: A Case Report. Front Hum Neurosci 2019; 13:314. [PMID: 31619978 PMCID: PMC6759570 DOI: 10.3389/fnhum.2019.00314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/22/2019] [Indexed: 12/14/2022] Open
Abstract
The treatment of writer’s cramp (W’sC) is essentially based on the use of botulinum toxin. However, additional treatments are sometime required to prolong the effects of the toxin, compensate for its progressive loss of efficacy in some subjects, and re-educate handwriting (e.g., rehabilitation strategies). Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been employed to improve W’sC, but with short-lasting and controversial outcomes. We report on the effects of a long-lasting low-frequency rTMS paradigm on W’sC symptoms. A 25-year-old male with a diagnosis of simple W’sC was enrolled in the study. He underwent an objective assessment using the Writer’s Cramp Rating Scale (WCRS) and the 1-min writing test. Further, we recorded muscle activation of the upper limb during handwriting using an EMG wireless system. The patient was provided with 1,200 biphasic magnetic pulses delivered at 1 Hz over the left premotor cortex (PMC), 15 times scheduled every 2 days, thus covering a period of 5 weeks, followed by 10 days of rest. This block of stimulations was practiced other four times, for a period of 6 months. The patient showed a gradual clinical improvement with the progression of the treatments. W’sC symptoms totally disappeared and all the clinical scores showed a significant improvement after rTMS completion. Such improvement lasted up to 1 year after the end of the treatment. Moreover, we detected a long-lasting improvement in sensorimotor plasticity as measured by a paired associative stimulation protocol. Our case suggests that the long-lasting application of 1 Hz rTMS to PMC is a safe and potentially valuable tool to improve W’sC symptoms enduringly, probably by reverting maladaptive plasticity mechanisms within the sensory-motor areas of the hemisphere contralateral to the dystonic hand.
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Affiliation(s)
- Antonino Naro
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Luana Billeri
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Simona Portaro
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Placido Bramanti
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Rocco Salvatore Calabrò
- Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
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31
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Conte A, Rocchi L, Latorre A, Belvisi D, Rothwell JC, Berardelli A. Ten‐Year Reflections on the Neurophysiological Abnormalities of Focal Dystonias in Humans. Mov Disord 2019; 34:1616-1628. [DOI: 10.1002/mds.27859] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- IRCCS Neuromed Pozzilli (IS) Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | - Anna Latorre
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | | | - John C. Rothwell
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK
| | - Alfredo Berardelli
- Department of Human Neurosciences Sapienza, University of Rome Rome Italy
- IRCCS Neuromed Pozzilli (IS) Italy
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32
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Tarrano C, Wattiez N, Delorme C, McGovern EM, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol J, Pedespan J, Krystkoviak P, Houeto J, Degardin A, Defebvre L, Valabrègue R, Vidailhet M, Pouget P, Roze E, Worbe Y. Visual Sensory Processing is Altered in Myoclonus Dystonia. Mov Disord 2019; 35:151-160. [DOI: 10.1002/mds.27857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/04/2019] [Accepted: 08/08/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Clément Tarrano
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
- Department of Neurology CHU Côte de Nacre, Université Caen Normandie Caen France
| | - Nicolas Wattiez
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Cécile Delorme
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Eavan M. McGovern
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
- Department of Neurology St Vincent's University Hospital Dublin Dublin Ireland
| | | | - Stéphane Thobois
- University of Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C Bron France
| | - Christine Tranchant
- Service de Neurologie Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM‐U964/CNRS‐UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg Strasbourg France
| | - David Grabli
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Bertrand Degos
- Assistance Publique‐Hôpitaux de Paris, Department of Neurology Hôpital Avicennes Bobigny France
| | - Jean‐Christophe Corvol
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | | | | | - Jean‐Luc Houeto
- Service de Neurologie, CIC‐INSERM 1402, CHU de Poitiers Poitiers France
| | - Adrian Degardin
- Department of Neurology Centre hospitalier de Tourcoing Tourcoing France
| | - Luc Defebvre
- Université de Lille, CHU Lille, INSERM, U1171–Degenerative & Vascular Cognitive Disorders, Lille, France; Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND) Lille France
| | - Romain Valabrègue
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Centre de NeuroImagerie de Recherche (CENIR) Sorbonne Université, UMR S 975, CNRS UMR 7225, ICM Paris France
| | - Marie Vidailhet
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Pierre Pouget
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
| | - Emmanuel Roze
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Yulia Worbe
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Department of Neurophysiology Saint‐Antoine Hospital, Assistance Publique‐Hôpitaux de Paris Paris France
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Modulation of inhibitory function in the primary somatosensory cortex and temporal discrimination threshold induced by acute aerobic exercise. Behav Brain Res 2019; 377:112253. [PMID: 31550485 DOI: 10.1016/j.bbr.2019.112253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 11/22/2022]
Abstract
Acute aerobic exercise beneficially affects brain function. The effect of acute aerobic exercise on the inhibitory mechanism of the primary somatosensory cortex (S1) and somatosensory function remains unclear. We investigated whether acute aerobic exercise modulates S1 inhibitory function and somatosensory function. In Experiment 1, we measured somatosensory evoked potentials (SEP) and paired-pulse inhibition (PPI) in 15 healthy right-handed participants. The right median nerve underwent electrical stimulation (ES). Interstimulus intervals were 5 ms, 30 ms, and 100 ms. In Experiment 2, we assessed the somatosensory function by using a somatosensory temporal discrimination task. Single or paired ES was applied to the distal phalanx of the right index finger. Both the experiments involved three sessions: 20 min of moderate-intensity exercise, 30 min of low-intensity exercise, and 30 min of seated rest. Before and after each session, PPI and somatosensory temporal discrimination task performance were measured. The N20 latency was significantly shortened immediately after moderate exercise. The SEP amplitude was not modulated in any session. The PPI at 30 ms (PPI_30ms) significantly decreased 20 min after moderate exercise, whereas the PPI at 5 ms (PPI_5ms) and PPI at 100 ms (PPI_100ms) did not change. The 50% and 75% thresholds and reaction time did not improve in any session. We found negative relationships between the change in PPI_5ms and the change in the 75% threshold under low-intensity exercise condition. Thus, acute aerobic exercise modulated S1 inhibitory function depending on exercise intensity. The exercise-induced change in PPI was associated with the change in temporal discrimination.
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Kızıltan ME, Yeni SN, Aliş C, Gündüz A. Recovery function of somatosensory evoked potentials in juvenile myoclonic epilepsy*. Somatosens Mot Res 2019; 36:195-201. [DOI: 10.1080/08990220.2019.1644999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Meral E. Kızıltan
- Department of Neurology, Cerrahpasa Medical Faculty, I.U.C., Istanbul, Turkey
| | - S. Naz Yeni
- Department of Neurology, Cerrahpasa Medical Faculty, I.U.C., Istanbul, Turkey
| | - Ceren Aliş
- Department of Neurology, Cerrahpasa Medical Faculty, I.U.C., Istanbul, Turkey
| | - Ayşegül Gündüz
- Department of Neurology, Cerrahpasa Medical Faculty, I.U.C., Istanbul, Turkey
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Desrochers P, Brunfeldt A, Sidiropoulos C, Kagerer F. Sensorimotor Control in Dystonia. Brain Sci 2019; 9:brainsci9040079. [PMID: 30979073 PMCID: PMC6523253 DOI: 10.3390/brainsci9040079] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 12/24/2022] Open
Abstract
This is an overview of the sensorimotor impairments in dystonia, a syndrome characterized by sustained or intermittent aberrant movement patterns leading to abnormal movements and/or postures with or without a tremulous component. Dystonia can affect the entire body or specific body regions and results from a plethora of etiologies, including subtle changes in gray and white matter in several brain regions. Research over the last 25 years addressing topics of sensorimotor control has shown functional sensorimotor impairments related to sensorimotor integration, timing, oculomotor and head control, as well as upper and lower limb control. In the context of efforts to update the classification of dystonia, sensorimotor research is highly relevant for a better understanding of the underlying pathology, and potential mechanisms contributing to global and regional dysfunction within the central nervous system. This overview of relevant research regarding sensorimotor control in humans with idiopathic dystonia attempts to frame the dysfunction with respect to what is known regarding motor control in patients and healthy individuals. We also highlight promising avenues for the future study of neuromotor control that may help to further elucidate dystonia etiology, pathology, and functional characteristics.
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Affiliation(s)
- Phillip Desrochers
- Dept. of Kinesiology, Michigan State University, East Lansing, MI 48824, USA.
| | - Alexander Brunfeldt
- Dept. of Kinesiology, Michigan State University, East Lansing, MI 48824, USA.
| | - Christos Sidiropoulos
- Dept. of Neurology and Ophthalmology, Michigan State University, East Lansing, MI 48824, USA.
| | - Florian Kagerer
- Dept. of Kinesiology, Michigan State University, East Lansing, MI 48824, USA.
- Neuroscience Program, Michigan State University, East Lansing, MI 48824, USA.
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36
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Brodoehl S, Wagner F, Prell T, Klingner C, Witte OW, Günther A. Cause or effect: Altered brain and network activity in cervical dystonia is partially normalized by botulinum toxin treatment. NEUROIMAGE-CLINICAL 2019; 22:101792. [PMID: 30928809 PMCID: PMC6444302 DOI: 10.1016/j.nicl.2019.101792] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/14/2019] [Accepted: 03/24/2019] [Indexed: 01/17/2023]
Abstract
Background Idiopathic cervical dystonia (CD) is a chronic movement disorder characterized by impressive clinical symptoms and the lack of clear pathological findings in clinical diagnostics and imaging. At present, the injection of botulinum toxin (BNT) in dystonic muscles is an effective therapy to control motor symptoms and pain in CD. Objectives We hypothesized that, although it is locally injected to dystonic muscles, BNT application leads to changes in brain and network activity towards normal brain function. Methods Using 3 T functional MR imaging along with advanced analysis techniques (functional connectivity, Granger causality, and regional homogeneity), we aimed to characterize brain activity in CD (17 CD patients vs. 17 controls) and to uncover the effects of BNT treatment (at 6 months). Results In CD, we observed an increased information flow within the basal ganglia, the thalamus, and the sensorimotor cortex. In parallel, some of these structures became less responsive to regulating inputs. Furthermore, our results suggested an altered somatosensory integration. Following BNT administration, we noted a shift towards normal brain function in the CD patients, especially within the motor cortex, the somatosensory cortex, and the basal ganglia. Conclusion The changes in brain function and network activity in CD can be interpreted as related to the underlying cause, the effort to compensate or a mixture of both. Although BNT is applied in the last stage of the cortico-neuromuscular pathway, brain patterns are shifted towards those of healthy controls. we characterized brain activity in CD and the effects of BNT using 3T fMR imaging and network analysis techniques following treatment with botulinum toxin (BNT), abnormal brain activity patterns in primary dystonia are attenuated critical key regions for both the pathophysiology and BNT-induced improvement in cervical dystonia are the BG
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Affiliation(s)
- Stefan Brodoehl
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany; Brain Imaging Center, Friedrich Schiller University Jena, Germany.
| | - Franziska Wagner
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany; Brain Imaging Center, Friedrich Schiller University Jena, Germany
| | - Tino Prell
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany; Center for Healthy Aging, Jena University Hospital, Jena, Germany
| | - Carsten Klingner
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany; Brain Imaging Center, Friedrich Schiller University Jena, Germany
| | - O W Witte
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany; Brain Imaging Center, Friedrich Schiller University Jena, Germany; Center for Healthy Aging, Jena University Hospital, Jena, Germany
| | - Albrecht Günther
- Hans Berger Department for Neurology, Friedrich Schiller University of Jena, Germany
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Abstract
PURPOSE OF REVIEW This survey takes into consideration the most recent advances in both human degenerative ataxias, disorders with a well established cerebellar origin, and discoveries from dystonia rodent models aimed at discussing the pathogenesis of dystonia. RECENT FINDINGS One common recurrent term that emerges when describing dystonia is heterogeneity. Indeed, dystonia encompasses a wide group of 'hyperkinetic' movement disorders, with heterogeneous causes, classification, anatomical and physiological substrates. In addition, the clinical heterogeneity of age at onset, symptom distribution and appearance of non-motor symptoms has supported the concept of dystonia as 'network' disorder. Pathophysiological alterations are thought to arise from dysfunction at cortico-thalamic-basal ganglia level, whereas, more recently, a role for cerebellar pathways emerged. Results from human and animal studies thus fuel the evolving concept of the network disorder. SUMMARY Current evidence suggests the involvement of multiple brain regions and cellular mechanisms, as part of the neural dysfunction observed at system level in dystonia.
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Spatial Integration of Somatosensory Inputs during Sensory-Motor Plasticity Phenomena Is Normal in Focal Hand Dystonia. Neural Plast 2018; 2018:4135708. [PMID: 30405710 PMCID: PMC6199881 DOI: 10.1155/2018/4135708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/18/2018] [Accepted: 08/29/2018] [Indexed: 11/28/2022] Open
Abstract
Background Surround inhibition is a system that sharpens sensation by creating an inhibitory zone around the central core of activation. In the motor system, this mechanism probably contributes to the selection of voluntary movements, and it seems to be lost in dystonia. Objectives. To explore if sensory information is abnormally processed and integrated in focal hand dystonia (FHD) and if surround inhibition phenomena are operating during sensory-motor plasticity and somatosensory integration in normal humans and in patients with FHD. Methods. We looked at the MEP facilitation obtained after 5 Hz repetitive paired associative stimulation of median (PAS M), ulnar (PAS U), and median + ulnar nerve (PAS MU) stimulation in 8 normal subjects and 8 FHD. We evaluated the ratio MU/(M + U) ∗ 100 and the spatial and temporal somatosensory integration recording the somatosensory evoked potentials (SEPs) evoked by a dual nerve input. Results FHD had two main abnormalities: first, the amount of facilitation was larger than normal subjects; second, the spatial specificity was lost. The MU/(M + U) ∗ 100 ratio was similar in healthy subjects and in FHD patients, and the somatosensory integration was normal in this subset of patients. Conclusions. The inhibitory integration of somatosensory inputs and the somatosensory inhibition are normal in patients with focal dystonia as well as lateral surrounding inhibition phenomena during sensory-motor plasticity in FHD.
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40
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Conte A, Belvisi D, De Bartolo MI, Manzo N, Cortese FN, Tartaglia M, Ferrazzano G, Fabbrini G, Berardelli A. Abnormal sensory gating in patients with different types of focal dystonias. Mov Disord 2018; 33:1910-1917. [DOI: 10.1002/mds.27530] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/08/2018] [Accepted: 08/23/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | | | | | - Nicoletta Manzo
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Matteo Tartaglia
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Giovanni Fabbrini
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
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41
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Lazar M, Butz M, Baumgarten TJ, Füllenbach ND, Jördens MS, Häussinger D, Schnitzler A, Lange J. Impaired Tactile Temporal Discrimination in Patients With Hepatic Encephalopathy. Front Psychol 2018; 9:2059. [PMID: 30425672 PMCID: PMC6218607 DOI: 10.3389/fpsyg.2018.02059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/05/2018] [Indexed: 12/29/2022] Open
Abstract
The sensory system constantly receives stimuli from the external world. To discriminate two stimuli correctly as two temporally distinct events, the temporal distance or stimulus onset asynchrony (SOA) between the two stimuli has to exceed a specific threshold. If the SOA between two stimuli is shorter than this specific threshold, the two stimuli will be perceptually fused and perceived as one single stimulus. Patients with hepatic encephalopathy (HE) are known to show manifold perceptual impairments, including slowed visual temporal discrimination abilities as measured by the critical flicker frequency (CFF). Here, we hypothesized that HE patients are also impaired in their tactile temporal discrimination abilities and, thus, require a longer SOA between two tactile stimuli to perceive the stimuli as two temporally distinct events. To test this hypothesis, patients with varying grades of HE and age-matched healthy individuals performed a tactile temporal discrimination task. All participants received two tactile stimuli with varying SOA applied to their left index finger and reported how many distinct stimuli they perceived ("1" vs. "2"). HE patients needed a significantly longer SOA (138.0 ± 11.3 ms) between two tactile stimuli to perceive the stimuli as two temporally distinct events than healthy controls (78.6 ± 13.1 ms; p < 0.01). In addition, we found that the temporal discrimination ability in the tactile modality correlated positively with the temporal discrimination ability in the visual domain across all participants (i.e., negative correlation between tactile SOA and visual CFF: r = -0.37, p = 0.033). Our findings provide evidence that temporal tactile perception is substantially impaired in HE patients. In addition, the results suggest that tactile and visual discrimination abilities are affected in HE in parallel. This finding might argue for a common underlying pathophysiological mechanism. We argue that the known global slowing of neuronal oscillations in HE might represent such a common mechanism.
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Affiliation(s)
- Moritz Lazar
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Markus Butz
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Thomas J Baumgarten
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Neuroscience Institute, Langone Medical Center, New York University, New York, NY, United States
| | - Nur-Deniz Füllenbach
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Markus S Jördens
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Joachim Lange
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Erro R, Rocchi L, Antelmi E, Liguori R, Tinazzi M, Berardelli A, Rothwell J, Bhatia KP. High frequency somatosensory stimulation in dystonia: Evidence fordefective inhibitory plasticity. Mov Disord 2018; 33:1902-1909. [PMID: 30376603 DOI: 10.1002/mds.27470] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/20/2018] [Accepted: 05/22/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Apart from motor symptoms, multiple deficits of sensory processing have been demonstrated in dystonia. The most consistent behavioural measure of this is abnormal somatosensory temporal discrimination threshold, which has recently been associated with physiological measures of reduced inhibition within the primary somatosensory area. High-frequency repetitive sensory stimulation is a patterned electric stimulation applied to the skin through surface electrodes that has been recently reported to shorten somatosensory temporal discrimination in healthy subjects and to increase the resting level of excitability in several different types of inhibitory interaction in the somatosensory and even motor areas. OBJECTIVES We tested whether high-frequency repetitive sensory stimulation could augment cortical inhibition and, in turn, ameliorate somatosensory temporal discrimination in cervical dystonia. METHODS Somatosensory temporal discrimination and a number of electrophysiological measures of sensorimotor inhibition and facilitation were measured before and after 45 minutes of high-frequency repetitive sensory stimulation. RESULTS As compared with a group of healthy volunteers of similar age, in whom high-frequency repetitive sensory stimulation increased inhibition and shortened somatosensory temporal discrimination, patients with cervical dystonia showed a consistent, paradoxical response: they had reduced suppression of paired-pulse somatosensory evoked potentials, as well as reduced high-frequency oscillations, lateral inhibition, and short interval intracortical inhibition. Somatosensory temporal discrimination deteriorated after the stimulation protocol, and correlated with reduced measures of inhibition within the primary somatosensory cortex. CONCLUSIONS We suggest that patients with dystonia have abnormal homeostatic inhibitory plasticity within the sensorimotor cortex and that this is responsible for their paradoxical response to high-frequency repetitive sensory stimulation. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.,Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana,", University of Salerno, Baronissi (Salerno), Italy
| | - Lorenzo Rocchi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.,Department of Neurology and Psychiatry, University of Rome "Sapienza,", Rome, Italy
| | - Elena Antelmi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Neurological Sciences, Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Neurological Sciences, Bologna, Italy
| | - Michele Tinazzi
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, University of Rome "Sapienza,", Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Neuromed Institute, Via Atinense, Pozzilli, Italy
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
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Liu YT, Chen YC, Kwan SY, Chou CC, Yu HY, Yen DJ, Liao KK, Chen WT, Lin YY, Chen RS, Jih KY, Lu SF, Wu YT, Wang PS, Hsiao FJ. Aberrant Sensory Gating of the Primary Somatosensory Cortex Contributes to the Motor Circuit Dysfunction in Paroxysmal Kinesigenic Dyskinesia. Front Neurol 2018; 9:831. [PMID: 30386286 PMCID: PMC6198142 DOI: 10.3389/fneur.2018.00831] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/18/2018] [Indexed: 12/19/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is conventionally regarded as a movement disorder (MD) and characterized by episodic hyperkinesia by sudden movements. However, patients of PKD often have sensory aura and respond excellently to antiepileptic agents. PRRT2 mutations, the most common genetic etiology of PKD, could cause epilepsy syndromes as well. Standing in the twilight zone between MDs and epilepsy, the pathogenesis of PKD is unclear. Gamma oscillations arise from the inhibitory interneurons which are crucial in the thalamocortical circuits. The role of synchronized gamma oscillations in sensory gating is an important mechanism of automatic cortical inhibition. The patterns of gamma oscillations have been used to characterize neurophysiological features of many neurological diseases, including epilepsy and MDs. This study was aimed to investigate the features of gamma synchronizations in PKD. In the paired-pulse electrical-stimulation task, we recorded the magnetoencephalographic data with distributed source modeling and time-frequency analysis in 19 patients of newly-diagnosed PKD without receiving pharmacotherapy and 18 healthy controls. In combination with the magnetic resonance imaging, the source of gamma oscillations was localized in the primary somatosensory cortex. Somatosensory evoked fields of PKD patients had a reduced peak frequency (p < 0.001 for the first and the second response) and a prolonged peak latency (the first response p = 0.02, the second response p = 0.002), indicating the synchronization of gamma oscillation is significantly attenuated. The power ratio between two responses was much higher in the PKD group (p = 0.013), indicating the incompetence of activity suppression. Aberrant gamma synchronizations revealed the defective sensory gating of the somatosensory area contributes the pathogenesis of PKD. Our findings documented disinhibited cortical function is a pathomechanism common to PKD and epilepsy, thus rationalized the clinical overlaps of these two diseases and the therapeutic effect of antiepileptic agents for PKD. There is a greater reduction of the peak gamma frequency in PRRT2-related PKD than the non-PRRT PKD group (p = 0.028 for the first response, p = 0.004 for the second response). Loss-of-function PRRT2 mutations could lead to synaptic dysfunction. The disinhibiton change on neurophysiology reflected the impacts of PRRT2 mutations on human neurophysiology.
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Affiliation(s)
- Yo-Tsen Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Chieh Chen
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Yeong Kwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Jen Yen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kwong-Kum Liao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Yang Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Rou-Shayn Chen
- Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kang-Yang Jih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Fen Lu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Te Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Po-Shan Wang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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Somatosensory temporal discrimination in Parkinson’s disease, dystonia and essential tremor: Pathophysiological and clinical implications. Clin Neurophysiol 2018; 129:1849-1853. [DOI: 10.1016/j.clinph.2018.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/23/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
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Abstract
Within the field of movement disorders, the conceptual understanding of dystonia has continued to evolve. Clinical advances have included improvements in recognition of certain features of dystonia, such as tremor, and understanding of phenotypic spectrums in the genetic dystonias and dystonia terminology and classification. Progress has also been made in the understanding of underlying biological processes which characterize dystonia from discoveries using approaches such as neurophysiology, functional imaging, genetics, and animal models. Important advances include the role of the cerebellum in dystonia, the concept of dystonia as an aberrant brain network disorder, additional evidence supporting the concept of dystonia endophenotypes, and new insights into psychogenic dystonia. These discoveries have begun to shape treatment approaches as, in parallel, important new treatment modalities, including magnetic resonance imaging-guided focused ultrasound, have emerged and existing interventions such as deep brain stimulation have been further refined. In this review, these topics are explored and discussed.
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Affiliation(s)
- Stephen Tisch
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,Department of Neurology, St Vincent's Hospital, Sydney, Australia
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46
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Avanzino L, Fiorio M, Conte A. Actual and Illusory Perception in Parkinson's Disease and Dystonia: A Narrative Review. Front Neurol 2018; 9:584. [PMID: 30079051 PMCID: PMC6062595 DOI: 10.3389/fneur.2018.00584] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022] Open
Abstract
Sensory information is continuously processed so as to allow behavior to be adjusted according to environmental changes. Before sensory information reaches the cortex, a number of subcortical neural structures select the relevant information to send to be consciously processed. In recent decades, several studies have shown that the pathophysiological mechanisms underlying movement disorders such as Parkinson's disease (PD) and dystonia involve sensory processing abnormalities related to proprioceptive and tactile information. These abnormalities emerge from psychophysical testing, mainly temporal discrimination, as well as from experimental paradigms based on bodily illusions. Although the link between proprioception and movement may be unequivocal, how temporal tactile information abnormalities and bodily illusions relate to motor disturbances in PD and dystonia is still a matter of debate. This review considers the role of altered sensory processing in the pathophysiology of movement disorders, focusing on how sensory alteration patterns differ between PD and dystonia. We also discuss the evidence available and the potential for developing new therapeutic strategies based on the manipulation of multi-sensory information and bodily illusions in patients with these movement disorders.
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Affiliation(s)
- Laura Avanzino
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Popa T, Hubsch C, James P, Richard A, Russo M, Pradeep S, Krishan S, Roze E, Meunier S, Kishore A. Abnormal cerebellar processing of the neck proprioceptive information drives dysfunctions in cervical dystonia. Sci Rep 2018; 8:2263. [PMID: 29396401 PMCID: PMC5797249 DOI: 10.1038/s41598-018-20510-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 12/20/2017] [Indexed: 01/11/2023] Open
Abstract
The cerebellum can influence the responsiveness of the primary motor cortex (M1) to undergo spike timing-dependent plastic changes through a complex mechanism involving multiple relays in the cerebello-thalamo-cortical pathway. Previous TMS studies showed that cerebellar cortex excitation can block the increase in M1 excitability induced by a paired-associative stimulation (PAS), while cerebellar cortex inhibition would enhance it. Since cerebellum is known to be affected in many types of dystonia, this bidirectional modulation was assessed in 22 patients with cervical dystonia and 23 healthy controls. Exactly opposite effects were found in patients: cerebellar inhibition suppressed the effects of PAS, while cerebellar excitation enhanced them. Another experiment comparing healthy subjects maintaining the head straight with subjects maintaining the head turned as the patients found that turning the head is enough to invert the cerebellar modulation of M1 plasticity. A third control experiment in healthy subjects showed that proprioceptive perturbation of the sterno-cleido-mastoid muscle had the same effects as turning the head. We discuss these finding in the light of the recent model of a mesencephalic head integrator. We also suggest that abnormal cerebellar processing of the neck proprioceptive information drives dysfunctions of the integrator in cervical dystonia.
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Affiliation(s)
- T Popa
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
| | - C Hubsch
- Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - P James
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - A Richard
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - M Russo
- Department of Neurosciences, University of Messina, Messina, Italy
| | - S Pradeep
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - S Krishan
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - E Roze
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Meunier
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - A Kishore
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
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Lee MS, Lee MJ, Conte A, Berardelli A. Abnormal somatosensory temporal discrimination in Parkinson’s disease: Pathophysiological correlates and role in motor control deficits. Clin Neurophysiol 2018; 129:442-447. [DOI: 10.1016/j.clinph.2017.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 12/14/2022]
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Postural control and the relation with cervical sensorimotor control in patients with idiopathic adult-onset cervical dystonia. Exp Brain Res 2018; 236:803-811. [PMID: 29340715 DOI: 10.1007/s00221-018-5174-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
Cervical dystonia (CD) is a movement disorder characterized by involuntary muscle contractions leading to an abnormal head posture or movements of the neck. Dysfunctions in somatosensory integration are present and previous data showed enlarged postural sway in stance. Postural control during quiet sitting and the correlation with cervical sensorimotor control were investigated. Postural control during quiet sitting was measured via body sway parameters in 23 patients with CD, regularly receiving botulinum toxin treatment and compared with 36 healthy controls. Amplitude and velocity of displacements of the center of pressure (CoP) were measured by two embedded force plates at 1000 Hz. Three samples of 30 s were recorded with the eyes open and closed. Disease-specific characteristics were obtained in all patients by the Tsui scale, Cervical Dystonia Impact Profile (CDIP-58) and Toronto Western Spasmodic Rating Scale (TWSTRS). Cervical sensorimotor control was assessed with an infrared Vicon system during a head repositioning task. Body sway amplitude and velocity were increased in patients with CD compared to healthy controls. CoP displacements were doubled in patients without head tremor and tripled in patients with a dystonic head tremor. Impairments in cervical sensorimotor control were correlated with larger CoP displacements (rs ranged from 0.608 to 0.748). Postural control is impaired and correlates with dysfunction in cervical sensorimotor control in patients with CD. Treatment is currently focused on the cervical area. Further research towards the potential value of postural control exercises is recommended.
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Jahanshahi M, Rothwell JC. Inhibitory dysfunction contributes to some of the motor and non-motor symptoms of movement disorders and psychiatric disorders. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2016.0198. [PMID: 28242732 DOI: 10.1098/rstb.2016.0198] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2016] [Indexed: 12/13/2022] Open
Abstract
Recently, it has been proposed that similar to goal-directed and habitual action mediated by the fronto-striatal circuits, the fronto-striato-subthalamic-pallidal-thalamo-cortical network may also mediate goal-directed and habitual (automatic) inhibition in both the motor and non-motor domains. Within this framework, some of the clinical manifestations of Parkinson's disease, dystonia, Tourette syndrome and obsessive-compulsive disorder can be considered to represent an imbalance between goal-directed and habitual action and inhibition. It is possible that surgical interventions targeting the basal ganglia nuclei, such as deep brain stimulation of the subthalamic nucleus or the internal segment of the globus pallidus, improve these disorders by restoring a functional balance between facilitation and inhibition in the fronto-striatal networks. These proposals require investigation in future studies.This article is part of the themed issue 'Movement suppression: brain mechanisms for stopping and stillness'.
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Affiliation(s)
- Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
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