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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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Fischer P, Piña-Fuentes D, Kassavetis P, Sadnicka A. Physiology of dystonia: Human studies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 169:137-162. [PMID: 37482391 DOI: 10.1016/bs.irn.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
In this chapter, we discuss neurophysiological techniques that have been used in the study of dystonia. We examine traditional disease models such as inhibition and excessive plasticity and review the evidence that these play a causal role in pathophysiology. We then review the evidence for sensory and peripheral influences within pathophysiology and look at an emergent literature that tries to probe how oscillatory brain activity may be linked to dystonia pathophysiology.
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Affiliation(s)
- Petra Fischer
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, Bristol, United Kingdom
| | - Dan Piña-Fuentes
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, The Netherlands; Department of Neurology, OLVG, Amsterdam, The Netherlands
| | | | - Anna Sadnicka
- Motor Control and Movement Disorders Group, St George's University of London, London, United Kingdom; Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
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Odorfer TM, Yabe M, Hiew S, Volkmann J, Zeller D. Topological differences and confounders of mental rotation in cervical dystonia and blepharospasm. Sci Rep 2023; 13:6026. [PMID: 37055560 PMCID: PMC10102235 DOI: 10.1038/s41598-023-33262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 04/15/2023] Open
Abstract
Mental rotation (mR) bases on imagination of actual movements. It remains unclear whether there is a specific pattern of mR impairment in focal dystonia. We aimed to investigate mR in patients with cervical dystonia (CD) and blepharospasm (BS) and to assess potential confounders. 23 CD patients and 23 healthy controls (HC) as well as 21 BS and 19 hemifacial spasm (HS) patients were matched for sex, age, and education level. Handedness, finger dexterity, general reaction time, and cognitive status were assessed. Disease severity was evaluated by clinical scales. During mR, photographs of body parts (head, hand, or foot) and a non-corporal object (car) were displayed at different angles rotated within their plane. Subjects were asked to judge laterality of the presented image by keystroke. Both speed and correctness were evaluated. Compared to HC, CD and HS patients performed worse in mR of hands, whereas BS group showed comparable performance. There was a significant association of prolonged mR reaction time (RT) with reduced MoCA scores and with increased RT in an unspecific reaction speed task. After exclusion of cognitively impaired patients, increased RT in the mR of hands was confined to CD group, but not HS. While the question of whether specific patterns of mR impairment reliably define a dystonic endophenotype remains elusive, our findings point to mR as a useful tool, when used carefully with control measures and tasks, which may be capable of identifying specific deficits that distinguish between subtypes of dystonia.
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Affiliation(s)
- Thorsten M Odorfer
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany.
| | - Marie Yabe
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Shawn Hiew
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, 97080, Würzburg, Germany
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Killian O, Hutchinson M, Reilly R. Neuromodulation in Dystonia - Harnessing the Network. ADVANCES IN NEUROBIOLOGY 2023; 31:177-194. [PMID: 37338702 DOI: 10.1007/978-3-031-26220-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Adult-onset isolated focal dystonia (AOIFD) is a network disorder characterised by abnormalities of sensory processing and motor control. These network abnormalities give rise to both the phenomenology of dystonia and the epiphenomena of altered plasticity and loss of intracortical inhibition. Existing modalities of deep brain stimulation effectively modulate parts of this network but are limited both in terms of targets and invasiveness. Novel approaches using a variety of non-invasive neuromodulation techniques including transcranial stimulation and peripheral stimulation present an interesting alternative approach and may, in conjunction with rehabilitative strategies, have a role in tailored therapies targeting the underlying network abnormality behind AOIFD.
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Affiliation(s)
- Owen Killian
- The Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - Richard Reilly
- School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.
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Borngräber F, Hoffmann M, Paulus T, Junker J, Bäumer T, Altenmüller E, Kühn AA, Schmidt A. Characterizing the temporal discrimination threshold in musician's dystonia. Sci Rep 2022; 12:14939. [PMID: 36056047 PMCID: PMC9440005 DOI: 10.1038/s41598-022-18739-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/18/2022] [Indexed: 11/28/2022] Open
Abstract
The temporal discrimination threshold (TDT) has been established as a biomarker of impaired temporal processing and endophenotype in various forms of focal dystonia patients, such as cervical dystonia, writer's cramp or blepharospasm. The role of TDT in musician's dystonia (MD) in contrast is less clear with preceding studies reporting inconclusive results. We therefore compared TDT between MD patients, healthy musicians and non-musician controls using a previously described visual, tactile, and visual-tactile paradigm. Additionally, we compared TDT of the dystonic and non-dystonic hand and fingers in MD patients and further characterized the biomarker regarding its potential influencing factors, i.e. musical activity, disease variables, and personality profiles. Repeated measures ANOVA and additional Bayesian analyses revealed lower TDT in healthy musicians compared to non-musicians. However, TDTs in MD patients did not differ from both healthy musicians and non-musicians, although pairwise Bayesian t-tests indicated weak evidence for group differences in both comparisons. Analyses of dystonic and non-dystonic hands and fingers revealed no differences. While in healthy musicians, age of first instrumental practice negatively correlated with visual-tactile TDTs, TDTs in MD patients did not correlate with measures of musical activity, disease variables or personality profiles. In conclusion, TDTs in MD patients cannot reliably be distinguished from healthy musicians and non-musicians and are neither influenced by dystonic manifestation, musical activity, disease variables nor personality profiles. Unlike other isolated focal dystonias, TDT seems not to be a reliable biomarker in MD.
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Affiliation(s)
- Friederike Borngräber
- Berlin Center for Musicians' Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin, Berlin, Germany.
- Charité-Universitätsmedizin Berlin, Movement Disorder and Neuromodulation Unit, Department of Neurology, Berlin, Germany.
- Berlin Institute of Health (BIH) at Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Martina Hoffmann
- Berlin Center for Musicians' Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin, Berlin, Germany
- Charité-Universitätsmedizin, Department of Neurology, Berlin, Germany
| | - Theresa Paulus
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Johanna Junker
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Tobias Bäumer
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Andrea A Kühn
- Charité-Universitätsmedizin Berlin, Movement Disorder and Neuromodulation Unit, Department of Neurology, Berlin, Germany
| | - Alexander Schmidt
- Berlin Center for Musicians' Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin, Berlin, Germany
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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: 3] [Impact Index Per Article: 1.5] [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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Sadnicka A, Daum C, Meppelink AM, Manohar S, Edwards M. Reduced drift rate: a biomarker of impaired information processing in functional movement disorders. Brain 2020; 143:674-683. [PMID: 31865371 DOI: 10.1093/brain/awz387] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
Functional neurological disorder is a common and phenomenologically diverse condition. Resultant disability is caused by both the dominant clinical presentation, e.g. paralysis or tremor and additional symptomatology such as cognitive symptoms. Recently the similarity of neuropsychiatric profiles across a range of functional syndromes has been highlighted. This is suggestive of a common underlying mechanism with a theoretical deficit of information processing proposed. Identification of an experimental biomarker for such deficits could offer novel assessment and therapeutic strategies. In this study, we took the temporal discrimination threshold as a paradigm that can be used to model sensory processing in functional movement disorders. Our hypothesis was that we would be able to delineate markers of slowed information processing in this paradigm removed from the phenomenological presentation with a movement disorder. We recorded both response accuracy and reaction time in a two-choice temporal resolution/discrimination task in 36 patients with functional movement disorders and 36 control subjects. A psychometric function was fitted to accuracy data for each individual revealing both abnormally high threshold values (P = 0.0053) and shallow psychometric slopes in patients (P = 0.0015). Patients with functional movement disorders also had significantly slower response times (P = 0.0065). We then used a well-established model for decision-making (the drift diffusion model) that uses both response accuracy and reaction time data to estimate mechanistic physiological dimensions of decision-making and sensory processing. This revealed pathologically reduced drift rate in the patient group, a parameter that quantifies the quality and rate of information accumulation within this sensory task (P = 0.002). We discuss how the deficits we observed in patients with functional movement disorders are likely to stem from abnormal allocation of attention that impairs the quality of sensory information available. Within a predictive coding framework sensory information could be down-weighted in favour of predictions encoded by the prior. Our results therefore offer a parsimonious account for a range of experimental and clinical findings. Reduced drift rate is a potential experimental marker for a generalized deficit in information processing across functional disorders that allows diverse symptomatology to be quantified under a common disease framework.
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Affiliation(s)
- 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
| | - Corinna Daum
- Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurology, Zug Cantonal Hospital, Baar, Switzerland
| | - Anne-Marthe Meppelink
- Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,SEIN - Stichting Epilepsie Instellingen Nederland, Zwolle, The Netherlands
| | - Sanjay Manohar
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mark Edwards
- Motor Control and Movement Disorders Group, St George's University of London, London, UK
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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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Junker J, Paulus T, Brandt V, Weissbach A, Tunc S, Loens S, Reilly RB, Hutchinson M, Baumer T. Temporal discrimination threshold and blink reflex recovery cycle in cervical dystonia - two sides of the same coin? Parkinsonism Relat Disord 2019; 68:4-7. [PMID: 31621616 DOI: 10.1016/j.parkreldis.2019.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 08/25/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Elevated temporal discrimination thresholds (TDT) have been found in cervical dystonia (CD) and unaffected first-degree relatives, indicating autosomal dominant inheritance with reduced penetrance, serving as an endophenotype and being indicative of abnormal inhibitory processing within the brainstem-basal ganglia circuits. The blink reflex R2 recovery cycle (BRRC) is also a measure of excitability of brainstem-basal ganglia circuits, and inconsistent findings are reported in CD. The aim was to investigate TDT and BRRC in CD and evaluate its reliability as an endophenotype. METHODS 29 patients with isolated cervical dystonia (mean age: 56.1 ± 14.3, female n = 18) and 29 age- and gender-matched healthy controls (mean age: 56.0 ± 14.2, female n = 18) were evaluated using a TDT-paradigm, performed as previously described by testing visual, tactile and visual-tactile temporal discrimination thresholds, and the BRRC, investigated with electrical and air puff stimulation. RESULTS Mean visual-tactile (p = 0.001) and visual TDTs (p = 0.015) differed between CD and controls; tactile TDTs revealed no group differences (p = 0.232). No between group differences were found for BRRC using either electrical or air puff stimulation (p = 0.117). There was no correlation between the elevation of TDTs and the degree of BRRC-inhibition in CD. CONCLUSION Our findings support the hypothesis that the TDT is an endophenotype in CD. BRRC testing did not demonstrate disinhibition of brainstem-basal ganglia circuits in CD. In contrast to TDT, the BRRC seems not to represent an endophenotype in cervical dystonia.
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Affiliation(s)
- Johanna Junker
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany; Department of Neurology, University of Luebeck, Luebeck, Germany
| | - Theresa Paulus
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Valerie Brandt
- Department of Psychology, Centre for Innovation in Mental Health, University of Southampton, UK
| | - Anne Weissbach
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Sinem Tunc
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany; Department of Neurology, University of Luebeck, Luebeck, Germany
| | - Sebastian Loens
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Richard B Reilly
- Department of Biomedical Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | | | - Tobias Baumer
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany.
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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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Gilbertson T, Humphries M, Steele JD. Maladaptive striatal plasticity and abnormal reward-learning in cervical dystonia. Eur J Neurosci 2019; 50:3191-3204. [PMID: 30955204 PMCID: PMC6900037 DOI: 10.1111/ejn.14414] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/12/2019] [Accepted: 03/27/2019] [Indexed: 01/18/2023]
Abstract
In monogenetic generalized forms of dystonia, in vitro neurophysiological recordings have demonstrated direct evidence for abnormal plasticity at the level of the cortico-striatal synapse. It is unclear whether similar abnormalities contribute to the pathophysiology of cervical dystonia, the most common type of focal dystonia. We investigated whether abnormal cortico-striatal synaptic plasticity contributes to abnormal reward-learning behavior in patients with focal dystonia. Forty patients and 40 controls performed a reward gain and loss avoidance reversal learning task. Participant's behavior was fitted to a computational model of the basal ganglia incorporating detailed cortico-striatal synaptic learning rules. Model comparisons were performed to assess the ability of four hypothesized receptor specific abnormalities of cortico-striatal long-term potentiation (LTP) and long-term depression (LTD): increased or decreased D1:LTP/LTD and increased or decreased D2: LTP/LTD to explain abnormal behavior in patients. Patients were selectively impaired in the post-reversal phase of the reward task. Individual learning rates in the reward reversal task correlated with the severity of the patient's motor symptoms. A model of the striatum with decreased D2:LTP/ LTD best explained the patient's behavior, suggesting excessive D2 cortico-striatal synaptic depotentiation could underpin biased reward-learning in patients with cervical dystonia. Reversal learning impairment in cervical dystonia may be a behavioral correlate of D2-specific abnormalities in cortico-striatal synaptic plasticity. Reinforcement learning tasks with computational modeling could allow the identification of molecular targets for novel treatments based on their ability to restore normal reward-learning behavior in these patients.
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Affiliation(s)
- Tom Gilbertson
- Department of NeurologyNinewells Hospital & Medical SchoolDundeeUK
- Division of Imaging Science and TechnologyMedical SchoolUniversity of DundeeDundeeUK
| | - Mark Humphries
- Division of Neuroscience & Experimental PsychologyUniversity of ManchesterManchesterUK
- School of PsychologyUniversity of NottinghamNottinghamUK
| | - J. Douglas Steele
- Division of Imaging Science and TechnologyMedical SchoolUniversity of DundeeDundeeUK
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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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Beudel M, Sadnicka A, Edwards M, de Jong BM. Linking Pathological Oscillations With Altered Temporal Processing in Parkinsons Disease: Neurophysiological Mechanisms and Implications for Neuromodulation. Front Neurol 2019; 10:462. [PMID: 31133967 PMCID: PMC6523774 DOI: 10.3389/fneur.2019.00462] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Abstract
Emerging evidence suggests that Parkinson's disease (PD) results from disrupted oscillatory activity in cortico-basal ganglia-thalamo-cortical (CBGTC) and cerebellar networks which can be partially corrected by applying deep brain stimulation (DBS). The inherent dynamic nature of such oscillatory activity might implicate that is represents temporal aspects of motor control. While the timing of muscle activities in CBGTC networks constitute the temporal dimensions of distinct motor acts, these very networks are also involved in somatosensory processing. In this respect, a temporal aspect of somatosensory processing in motor control concerns matching predicted (feedforward) and actual (feedback) sensory consequences of movement which implies a distinct contribution to demarcating the temporal order of events. Emerging evidence shows that such somatosensory processing is altered in movement disorders. This raises the question how disrupted oscillatory activity is related to impaired temporal processing and how/whether DBS can functionally restore this. In this perspective article, the neural underpinnings of temporal processing will be reviewed and translated to the specific alternated oscillatory neural activity specifically found in Parkinson's disease. These findings will be integrated in a neurophysiological framework linking somatosensory and motor processing. Finally, future implications for neuromodulation will be discussed with potential implications for strategy across a range of movement disorders.
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Affiliation(s)
- Martijn Beudel
- Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam University Medical Center, Amsterdam, Netherlands.,Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anna Sadnicka
- Faculty of Brain Sciences, Institute of Neurology, University College London, London, United Kingdom.,Department of Neurology, St. George's University of London, London, United Kingdom
| | - Mark Edwards
- Department of Neurology, St. George's University of London, London, United Kingdom
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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15
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16
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Schapira AHV. Progress in neurology 2017-2018. Eur J Neurol 2018; 25:1389-1397. [DOI: 10.1111/ene.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. H. V. Schapira
- Department of Clinical and Movement Neurosciences; UCL Queen Square Institute of Neurology; London UK
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17
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Chen JC, Macerollo A, Sadnicka A, Lu MK, Tsai CH, Korlipara P, Bhatia K, Rothwell JC, Edwards MJ. Cervical dystonia: Normal auditory mismatch negativity and abnormal somatosensory mismatch negativity. Clin Neurophysiol 2018; 129:1947-1954. [PMID: 30015084 DOI: 10.1016/j.clinph.2018.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/16/2018] [Accepted: 05/28/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Previous electrophysiological and psychophysical tests have suggested that somatosensory integration is abnormal in dystonia. Here, we hypothesised that this abnormality could relate to a more general deficit in pre-attentive error/deviant detection in patients with dystonia. We therefore tested patients with dystonia and healthy subjects using a mismatch negativity paradigm (MMN), where evoked potentials generated in response to a standard repeated stimulus are subtracted from the responses to a rare "odd ball" stimulus. METHODS We assessed MMN for somatosensory and auditory stimuli in patients with cervical dystonia and healthy age matched controls. RESULTS We found a significant group ∗ oddball type interaction effect (F (1, 34) = 4.5, p = 0.04, ρI = 0.63). A follow up independent t-test for sMMN data, showed a smaller sMMN amplitude in dystonic patients compared to controls (mean difference control-dystonia: -1.0 µV ± 0.3, p < 0.00, t = -3.1). However the amplitude of aMMN did not differ between groups (mean difference control-dystonia: -0.2 µV ± 0.2, p = 0.24, t = -1.2). We found a positive correlation between somatosensory MMN and somatosensory temporal discrimination threshold. CONCLUSION These results suggest that pre-attentive error/deviant detection, specifically in the somatosensory domain, is abnormal in dystonia. This could underlie some previously reported electrophysiological and psychophysical abnormalities of somatosensory integration in dystonia. SIGNIFICANCE One could hypothesize a deficit in pre-conscious orientation towards potentially salient signals might lead to a more conservative threshold for decision-making in dystonia.
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Affiliation(s)
- Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Anna Sadnicka
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Min-Kuei Lu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Prasad Korlipara
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Kailash Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Mark J Edwards
- Department of Molecular and Clinical Sciences, St George's University of London, London
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18
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Cortical inhibitory function in cervical dystonia. Clin Neurophysiol 2018; 129:466-472. [DOI: 10.1016/j.clinph.2017.11.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/18/2017] [Accepted: 11/18/2017] [Indexed: 11/23/2022]
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19
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Chen R. Spatial versus temporal inhibition in dystonia. Clin Neurophysiol 2018; 129:458-459. [PMID: 29305207 DOI: 10.1016/j.clinph.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Research Institute, University Health Network, 7McL409, 399 Bathurst St, Toronto, Ontario M5T 2S8, Canada.
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