1
|
Corp DT, Morrison-Ham J, Jinnah HA, Joutsa J. The functional anatomy of dystonia: Recent developments. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 169:105-136. [PMID: 37482390 DOI: 10.1016/bs.irn.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
While dystonia has traditionally been viewed as a disorder of the basal ganglia, the involvement of other key brain structures is now accepted. However, just what these structures are remains to be defined. Neuroimaging has been an especially valuable tool in dystonia, yet traditional cross-sectional designs have not been able to separate causal from compensatory brain activity. Therefore, this chapter discusses recent studies using causal brain lesions, and animal models, to converge upon the brain regions responsible for dystonia with increasing precision. This evidence strongly implicates the basal ganglia, thalamus, brainstem, cerebellum, and somatosensory cortex, yet shows that different types of dystonia involve different nodes of this brain network. Nearly all of these nodes fall within the recently identified two-way networks connecting the basal ganglia and cerebellum, suggesting dysfunction of these specific pathways. Localisation of the functional anatomy of dystonia has strong implications for targeted treatment options, such as deep brain stimulation, and non-invasive brain stimulation.
Collapse
Affiliation(s)
- Daniel T Corp
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, MA, United States.
| | - Jordan Morrison-Ham
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - H A Jinnah
- Departments of Neurology, Human Genetics, and Pediatrics, Atlanta, GA, United States
| | - Juho Joutsa
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, MA, United States; Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, Finland; Turku PET Centre, Neurocenter, Turku University Hospital, Turku, Finland
| |
Collapse
|
2
|
Morrison-Ham J, Clark GM, Ellis EG, Cerins A, Joutsa J, Enticott PG, Corp DT. Effects of non-invasive brain stimulation in dystonia: a systematic review and meta-analysis. Ther Adv Neurol Disord 2022; 15:17562864221138144. [PMID: 36583118 PMCID: PMC9793065 DOI: 10.1177/17562864221138144] [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: 04/12/2022] [Accepted: 10/21/2022] [Indexed: 12/24/2022] Open
Abstract
Background Deep brain stimulation is a highly effective treatment of dystonia but is invasive and associated with risks, such as intraoperative bleeding and infections. Previous research has used non-invasive brain stimulation (NIBS) in an attempt to alleviate symptoms of dystonia. The results of these studies, however, have been variable, leaving efficacy unclear. Objectives This study aimed to evaluate the effects of NIBS on symptoms of dystonia and determine whether methodological characteristics are associated with variability in effect size. Methods Web of Science, Embase, and MEDLINE Complete databases were searched for articles using any type of NIBS as an intervention in dystonia patients, with changes in dystonia symptoms the primary outcome of interest. Results Meta-analysis of 27 studies demonstrated a small effect size for NIBS in reducing symptoms of dystonia (random-effects Hedges' g = 0.21, p = .002). Differences in the type of NIBS, type of dystonia, and brain region stimulated had a significant effect on dystonia symptoms. Meta-regression revealed that 10 sessions of active stimulation and the application of concurrent motor training programs resulted in significantly larger mean effect sizes. Conclusion NIBS has yielded small improvements to dystonic symptoms, but effect sizes depended on methodological characteristics, with more sessions of stimulation producing a larger response. Future research should further investigate the application of NIBS parallel to motor training, in addition to providing a greater quantity of sessions, to help define optimal parameters for NIBS protocols in dystonia. Registration PROSPERO 2020, CRD42020175944.
Collapse
Affiliation(s)
| | - Gillian M. Clark
- Cognitive Neuroscience Unit, School of
Psychology, Deakin University, Geelong, VIC, Australia
| | - Elizabeth G. Ellis
- Cognitive Neuroscience Unit, School of
Psychology, Deakin University, Geelong, VIC, Australia
| | - Andris Cerins
- Cognitive Neuroscience Unit, School of
Psychology, Deakin University, Geelong, VIC, Australia
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical
Neurosciences, University of Turku, Turku, Finland,Turku PET Centre, Neurocenter, Turku University
Hospital, Turku, Finland
| | - Peter G. Enticott
- Cognitive Neuroscience Unit, School of
Psychology, Deakin University, Geelong, VIC, Australia
| | - Daniel T. Corp
- Cognitive Neuroscience Unit, School of
Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125,
Australia,Center for Brain Circuit Therapeutics, Brigham
and Women’s Hospital, Boston, MA, USA
| |
Collapse
|
3
|
Manto M, Argyropoulos GPD, Bocci T, Celnik PA, Corben LA, Guidetti M, Koch G, Priori A, Rothwell JC, Sadnicka A, Spampinato D, Ugawa Y, Wessel MJ, Ferrucci R. Consensus Paper: Novel Directions and Next Steps of Non-invasive Brain Stimulation of the Cerebellum in Health and Disease. CEREBELLUM (LONDON, ENGLAND) 2021; 21:1092-1122. [PMID: 34813040 DOI: 10.1007/s12311-021-01344-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/11/2022]
Abstract
The cerebellum is involved in multiple closed-loops circuitry which connect the cerebellar modules with the motor cortex, prefrontal, temporal, and parietal cortical areas, and contribute to motor control, cognitive processes, emotional processing, and behavior. Among them, the cerebello-thalamo-cortical pathway represents the anatomical substratum of cerebellum-motor cortex inhibition (CBI). However, the cerebellum is also connected with basal ganglia by disynaptic pathways, and cerebellar involvement in disorders commonly associated with basal ganglia dysfunction (e.g., Parkinson's disease and dystonia) has been suggested. Lately, cerebellar activity has been targeted by non-invasive brain stimulation (NIBS) techniques including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) to indirectly affect and tune dysfunctional circuitry in the brain. Although the results are promising, several questions remain still unsolved. Here, a panel of experts from different specialties (neurophysiology, neurology, neurosurgery, neuropsychology) reviews the current results on cerebellar NIBS with the aim to derive the future steps and directions needed. We discuss the effects of TMS in the field of cerebellar neurophysiology, the potentials of cerebellar tDCS, the role of animal models in cerebellar NIBS applications, and the possible application of cerebellar NIBS in motor learning, stroke recovery, speech and language functions, neuropsychiatric and movement disorders.
Collapse
Affiliation(s)
- Mario Manto
- Service de Neurologie, CHU-Charleroi, 6000, Charleroi, Belgium.,Service Des Neurosciences, UMons, 7000, Mons, Belgium
| | - Georgios P D Argyropoulos
- Division of Psychology, Faculty of Natural Sciences, Faculty of Natural Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Tommaso Bocci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142, Milan, Italy.,ASST Santi Paolo E Carlo, Via di Rudinì, 8, 20142, Milan, Italy
| | - Pablo A Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Parkville. Victoria, Australia
| | - Matteo Guidetti
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142, Milan, Italy.,Department of Electronics, Information and Bioengineering, Politecnico Di Milano, 20133, Milan, Italy
| | - Giacomo Koch
- Fondazione Santa Lucia IRCCS, via Ardeatina 306, 00179, Rome, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142, Milan, Italy.,ASST Santi Paolo E Carlo, Via di Rudinì, 8, 20142, Milan, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Anna Sadnicka
- Motor Control and Movement Disorders Group, St George's University of London, London, UK.,Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Danny Spampinato
- Fondazione Santa Lucia IRCCS, via Ardeatina 306, 00179, Rome, Italy
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | - Maximilian J Wessel
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland
| | - Roberta Ferrucci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142, Milan, Italy. .,ASST Santi Paolo E Carlo, Via di Rudinì, 8, 20142, Milan, Italy.
| |
Collapse
|
4
|
Serrazina F, Ramos J, Correia AS, Barbosa R, Mendonça M. Delayed onset of dystonia 18 years after a cerebellar injury. Neurol Sci 2021; 42:4321-4323. [PMID: 34173931 DOI: 10.1007/s10072-021-05340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Filipa Serrazina
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
| | - João Ramos
- Neuroradiology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Ana Sofia Correia
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.,CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal
| | - Raquel Barbosa
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.,CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal
| | - Marcelo Mendonça
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal. .,CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal. .,Champalimaud Research, Champalimaud Centre for the Unknown, Lisboa, Portugal.
| |
Collapse
|