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Chen KHS, Kuo YCJ, Dong YS, Chen R. Involvement of interhemispheric inhibition in ballistic movement-induced transient suppression of voluntary movement. Clin Neurophysiol 2024; 157:44-45. [PMID: 38042012 DOI: 10.1016/j.clinph.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
| | - Yih-Chih Jacinta Kuo
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Yan-Siou Dong
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, University Health Network, Toronto, Ontario, Canada.
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Quattrone A, Latorre A, Magrinelli F, Mulroy E, Rajan R, Neo RJ, Quattrone A, Rothwell JC, Bhatia KP. A Reflection on Motor Overflow, Mirror Phenomena, Synkinesia and Entrainment. Mov Disord Clin Pract 2023; 10:1243-1252. [PMID: 37772299 PMCID: PMC10525069 DOI: 10.1002/mdc3.13798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 09/30/2023] Open
Abstract
In patients with movement disorders, voluntary movements can sometimes be accompanied by unintentional muscle contractions in other body regions. In this review, we discuss clinical and pathophysiological aspects of several motor phenomena including mirror movements, dystonic overflow, synkinesia, entrainment and mirror dystonia, focusing on their similarities and differences. These phenomena share some common clinical and pathophysiological features, which often leads to confusion in their definition. However, they differ in several aspects, such as the body part showing the undesired movement, the type of this movement (identical or not to the intentional movement), the underlying neurological condition, and the role of primary motor areas, descending pathways and inhibitory circuits involved, suggesting that these are distinct phenomena. We summarize the main features of these fascinating clinical signs aiming to improve the clinical recognition and standardize the terminology in research studies. We also suggest that the term "mirror dystonia" may be not appropriate to describe this peculiar phenomenon which may be closer to dystonic overflow rather than to the classical mirror movements.
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Affiliation(s)
- Andrea Quattrone
- Institute of NeurologyUniversity “Magna Graecia”CatanzaroItaly
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Francesca Magrinelli
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Eoin Mulroy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Roopa Rajan
- Department of NeurologyAll India Institute of Medical Sciences (AIIMS)New DelhiIndia
| | - Ray Jen Neo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Department of NeurologyHospital Kuala LumpurKuala LumpurMalaysia
| | - Aldo Quattrone
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Graecia”CatanzaroItaly
| | - John C. Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Kailash P. Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
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Vucic S, Stanley Chen KH, Kiernan MC, Hallett M, Benninger DH, Di Lazzaro V, Rossini PM, Benussi A, Berardelli A, Currà A, Krieg SM, Lefaucheur JP, Long Lo Y, Macdonell RA, Massimini M, Rosanova M, Picht T, Stinear CM, Paulus W, Ugawa Y, Ziemann U, Chen R. Clinical diagnostic utility of transcranial magnetic stimulation in neurological disorders. Updated report of an IFCN committee. Clin Neurophysiol 2023; 150:131-175. [PMID: 37068329 PMCID: PMC10192339 DOI: 10.1016/j.clinph.2023.03.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
The review provides a comprehensive update (previous report: Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, et al. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2008;119(3):504-32) on clinical diagnostic utility of transcranial magnetic stimulation (TMS) in neurological diseases. Most TMS measures rely on stimulation of motor cortex and recording of motor evoked potentials. Paired-pulse TMS techniques, incorporating conventional amplitude-based and threshold tracking, have established clinical utility in neurodegenerative, movement, episodic (epilepsy, migraines), chronic pain and functional diseases. Cortical hyperexcitability has emerged as a diagnostic aid in amyotrophic lateral sclerosis. Single-pulse TMS measures are of utility in stroke, and myelopathy even in the absence of radiological changes. Short-latency afferent inhibition, related to central cholinergic transmission, is reduced in Alzheimer's disease. The triple stimulation technique (TST) may enhance diagnostic utility of conventional TMS measures to detect upper motor neuron involvement. The recording of motor evoked potentials can be used to perform functional mapping of the motor cortex or in preoperative assessment of eloquent brain regions before surgical resection of brain tumors. TMS exhibits utility in assessing lumbosacral/cervical nerve root function, especially in demyelinating neuropathies, and may be of utility in localizing the site of facial nerve palsies. TMS measures also have high sensitivity in detecting subclinical corticospinal lesions in multiple sclerosis. Abnormalities in central motor conduction time or TST correlate with motor impairment and disability in MS. Cerebellar stimulation may detect lesions in the cerebellum or cerebello-dentato-thalamo-motor cortical pathways. Combining TMS with electroencephalography, provides a novel method to measure parameters altered in neurological disorders, including cortical excitability, effective connectivity, and response complexity.
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Affiliation(s)
- Steve Vucic
- Brain, Nerve Research Center, The University of Sydney, Sydney, Australia.
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney; and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, Maryland, United States
| | - David H Benninger
- Department of Neurology, University Hospital of Lausanne (CHUV), Switzerland
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Paolo M Rossini
- Department of Neurosci & Neurorehab IRCCS San Raffaele-Rome, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Currà
- Department of Medico-Surgical Sciences and Biotechnologies, Alfredo Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Yew Long Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, and Duke-NUS Medical School, Singapore
| | | | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences University of Milan, Milan, Italy
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material," Humboldt University, Berlin Simulation and Training Center (BeST), Charité-Universitätsmedizin Berlin, Germany
| | - Cathy M Stinear
- Department of Medicine Waipapa Taumata Rau, University of Auckland, Auckland, Aotearoa, New Zealand
| | - Walter Paulus
- Department of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Japan
| | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard Karls University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, Division of Neurology-University of Toronto, Toronto Canada
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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: 0] [Impact Index Per Article: 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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di Biase L, Di Santo A, Caminiti ML, Pecoraro PM, Carbone SP, Di Lazzaro V. Dystonia Diagnosis: Clinical Neurophysiology and Genetics. J Clin Med 2022; 11:jcm11144184. [PMID: 35887948 PMCID: PMC9320296 DOI: 10.3390/jcm11144184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/16/2022] [Indexed: 12/12/2022] Open
Abstract
Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. Neurophysiology played a role in untangling dystonia pathophysiology, demonstrating characteristic reduction in inhibition of central motor circuits and alterations in the somatosensory system. The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). Other parameters need further confirmations and more solid evidence to be considered as support for the dystonia diagnosis. Genetic testing should be guided by characteristics such as age at onset, body distribution, associated features, and coexistence of other movement disorders (parkinsonism, myoclonus, and other hyperkinesia). The aim of the present review is to summarize the state of the art regarding dystonia diagnosis focusing on the role of neurophysiology and genetic testing.
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Affiliation(s)
- Lazzaro di Biase
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
- Brain Innovations Lab., Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
- Correspondence: or ; Tel.: +39-062-2541-1220
| | - Alessandro Di Santo
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Maria Letizia Caminiti
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Pasquale Maria Pecoraro
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Simona Paola Carbone
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Vincenzo Di Lazzaro
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy; (A.D.S.); (M.L.C.); (P.M.P.); (S.P.C.); (V.D.L.)
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Via Álvaro del Portillo 21, 00128 Rome, Italy
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Impact of interhemispheric inhibition on bimanual movement control in young and old. Exp Brain Res 2022; 240:687-701. [PMID: 35020040 PMCID: PMC8858275 DOI: 10.1007/s00221-021-06258-7] [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: 05/16/2021] [Accepted: 10/23/2021] [Indexed: 12/05/2022]
Abstract
Interhemispheric interactions demonstrate a crucial role for directing bimanual movement control. In humans, a well-established paired-pulse transcranial magnetic stimulation paradigm enables to assess these interactions by means of interhemispheric inhibition (IHI). Previous studies have examined changes in IHI from the active to the resting primary motor cortex during unilateral muscle contractions; however, behavioral relevance of such changes is still inconclusive. In the present study, we evaluated two bimanual tasks, i.e., mirror activity and bimanual anti-phase tapping, to examine behavioral relevance of IHI for bimanual movement control within this behavioral framework. Two age groups (young and older) were evaluated as bimanual movement control demonstrates evident behavioral decline in older adults. Two types of IHI with differential underlying mechanisms were measured; IHI was tested at rest and during a motor task from the active to the resting primary motor cortex. Results demonstrate an association between behavior and short-latency IHI in the young group: larger short-latency IHI correlated with better bimanual movement control (i.e., less mirror activity and better bimanual anti-phase tapping). These results support the view that short-latency IHI represents a neurophysiological marker for the ability to suppress activity of the contralateral side, likely contributing to efficient bimanual movement control. This association was not observed in the older group, suggesting age-related functional changes of IHI. To determine underlying mechanisms of impaired bimanual movement control due to neurological disorders, it is crucial to have an in-depth understanding of age-related mechanisms to disentangle disorder-related mechanisms of impaired bimanual movement control from age-related ones.
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Wei HT, Francois-Nienaber A, Deschamps T, Bellana B, Hebscher M, Sivaratnam G, Zadeh M, Meltzer JA. Sensitivity of amplitude and phase based MEG measures of interhemispheric connectivity during unilateral finger movements. Neuroimage 2021; 242:118457. [PMID: 34363959 DOI: 10.1016/j.neuroimage.2021.118457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/03/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
Interactions between different brain regions can be revealed by dependencies between their neuronal oscillations. We examined the sensitivity of different oscillatory connectivity measures in revealing interhemispheric interactions between primary motor cortices (M1s) during unilateral finger movements. Based on frequency, amplitude, and phase of the oscillations, a number of metrics have been developed to measure connectivity between brain regions, and each metric has its own strengths, weaknesses, and pitfalls. Taking advantage of the well-known movement-related modulations of oscillatory amplitude in M1s, this study compared and contrasted a number of leading connectivity metrics during distinct phases of oscillatory power changes. Between M1s during unilateral movements, we found that phase-based metrics were effective at revealing connectivity during the beta (15-35 Hz) rebound period linked to movement termination, but not during the early period of beta desynchronization occurring during the movement itself. Amplitude correlation metrics revealed robust connectivity during both periods. Techniques for estimating the direction of connectivity had limited success. Granger Causality was not well suited to studying these connections because it was strongly confounded by differences in signal-to-noise ratio linked to modulation of beta amplitude occurring during the task. Phase slope index was suggestive but not conclusive of a unidirectional influence between motor cortices during the beta rebound. Our findings suggest that a combination of amplitude and phase-based metrics is likely required to fully characterize connectivity during task protocols that involve modulation of oscillatory power, and that amplitude-based metrics appear to be more sensitive despite the lack of directional information.
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Affiliation(s)
- Hsi T Wei
- Department of Psychology, University of Toronto, Canada; Rotman Research Institute, Baycrest Hospital, Canada.
| | | | | | - Buddhika Bellana
- Rotman Research Institute, Baycrest Hospital, Canada; Department of Psychological and Brain Sciences, Johns Hopkins University, United States
| | - Melissa Hebscher
- Rotman Research Institute, Baycrest Hospital, Canada; Feinberg School of Medicine, Northwestern University, United States
| | | | - Maryam Zadeh
- Rotman Research Institute, Baycrest Hospital, Canada
| | - Jed A Meltzer
- Department of Psychology, University of Toronto, Canada; Rotman Research Institute, Baycrest Hospital, Canada; Department of Speech-Language Pathology, University of Toronto, Canada
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Heerdegen M, Zwar M, Franz D, Hörnschemeyer MF, Neubert V, Plocksties F, Niemann C, Timmermann D, Bahls C, van Rienen U, Paap M, Perl S, Lüttig A, Richter A, Köhling R. Mechanisms of pallidal deep brain stimulation: Alteration of cortico-striatal synaptic communication in a dystonia animal model. Neurobiol Dis 2021; 154:105341. [PMID: 33753292 DOI: 10.1016/j.nbd.2021.105341] [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: 11/17/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022] Open
Abstract
Pallidal deep brain stimulation (DBS) is an important option for patients with severe dystonias, which are thought to arise from a disturbance in striatal control of the globus pallidus internus (GPi). The mechanisms of GPi-DBS are far from understood. Although a disturbance of striatal function is thought to play a key role in dystonia, the effects of DBS on cortico-striatal function are unknown. We hypothesised that DBS, via axonal backfiring, or indirectly via thalamic and cortical coupling, alters striatal function. We tested this hypothesis in the dtsz hamster, an animal model of inherited generalised, paroxysmal dystonia. Hamsters (dystonic and non-dystonic controls) were bilaterally implanted with stimulation electrodes in the GPi. DBS (130 Hz), and sham DBS, were performed in unanaesthetised animals for 3 h. Synaptic cortico-striatal field potentials, as well as miniature excitatory postsynaptic currents (mEPSC) and firing properties of medium spiny striatal neurones were recorded in brain slice preparations obtained immediately after EPN-DBS. The main findings were as follows: a. DBS increased cortico-striatal evoked responses in healthy, but not in dystonic tissue. b. Commensurate with this, DBS increased inhibitory control of these evoked responses in dystonic, and decreased inhibitory control in healthy tissue. c. Further, DBS reduced mEPSC frequency strongly in dystonic, and less prominently in healthy tissue, showing that also a modulation of presynaptic mechanisms is likely involved. d. Cellular properties of medium-spiny neurones remained unchanged. We conclude that DBS leads to dampening of cortico-striatal communication, and restores intrastriatal inhibitory tone.
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Affiliation(s)
- Marco Heerdegen
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Monique Zwar
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Denise Franz
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | | | - Valentin Neubert
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Franz Plocksties
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Christoph Niemann
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Dirk Timmermann
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Christian Bahls
- Institute of General Electrical Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Ursula van Rienen
- Institute of General Electrical Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany; Department Life, Light & Matter, University of Rostock, Germany
| | - Maria Paap
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Stefanie Perl
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Anika Lüttig
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Angelika Richter
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Rüdiger Köhling
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany; Department of Ageing of Individuals and Society, University of Rostock, Germany.
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Taga M, Curci A, Pizzamigglio S, Lacal I, Turner DL, Fu CHY. Motor adaptation and internal model formation in a robot-mediated forcefield. PSYCHORADIOLOGY 2021; 1:73-87. [PMID: 38665359 PMCID: PMC10917215 DOI: 10.1093/psyrad/kkab007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/28/2021] [Accepted: 05/15/2021] [Indexed: 04/28/2024]
Abstract
Background Motor adaptation relies on error-based learning for accurate movements in changing environments. However, the neurophysiological mechanisms driving individual differences in performance are unclear. Transcranial magnetic stimulation (TMS)-evoked potential can provide a direct measure of cortical excitability. Objective To investigate cortical excitability as a predictor of motor learning and motor adaptation in a robot-mediated forcefield. Methods A group of 15 right-handed healthy participants (mean age 23 years) performed a robot-mediated forcefield perturbation task. There were two conditions: unperturbed non-adaptation and perturbed adaptation. TMS was applied in the resting state at baseline and following motor adaptation over the contralateral primary motor cortex (left M1). Electroencephalographic (EEG) activity was continuously recorded, and cortical excitability was measured by TMS-evoked potential (TEP). Motor learning was quantified by the motor learning index. Results Larger error-related negativity (ERN) in fronto-central regions was associated with improved motor performance as measured by a reduction in trajectory errors. Baseline TEP N100 peak amplitude predicted motor learning (P = 0.005), which was significantly attenuated relative to baseline (P = 0.0018) following motor adaptation. Conclusions ERN reflected the formation of a predictive internal model adapted to the forcefield perturbation. Attenuation in TEP N100 amplitude reflected an increase in cortical excitability with motor adaptation reflecting neuroplastic changes in the sensorimotor cortex. TEP N100 is a potential biomarker for predicting the outcome in robot-mediated therapy and a mechanism to investigate psychomotor abnormalities in depression.
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Affiliation(s)
- Myriam Taga
- School of Health, Sports and Bioscience, University of East London, London, UK
| | - Annacarmen Curci
- School of Health, Sports and Bioscience, University of East London, London, UK
| | - Sara Pizzamigglio
- Department of Computer Science, School of Architecture, Computing and Engineering, University of East London, London, UK
| | - Irene Lacal
- Department of Computer Science, School of Architecture, Computing and Engineering, University of East London, London, UK
| | - Duncan L Turner
- School of Health, Sports and Bioscience, University of East London, London, UK
| | - Cynthia H Y Fu
- Department of Physiology and Pharmacology, Sapienza University, Rome, Italy
- School of Psychology, University of East London, London, UK
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Ganguly J, Kulshreshtha D, Almotiri M, Jog M. Muscle Tone Physiology and Abnormalities. Toxins (Basel) 2021; 13:toxins13040282. [PMID: 33923397 PMCID: PMC8071570 DOI: 10.3390/toxins13040282] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 01/10/2023] Open
Abstract
The simple definition of tone as the resistance to passive stretch is physiologically a complex interlaced network encompassing neural circuits in the brain, spinal cord, and muscle spindle. Disorders of muscle tone can arise from dysfunction in these pathways and manifest as hypertonia or hypotonia. The loss of supraspinal control mechanisms gives rise to hypertonia, resulting in spasticity or rigidity. On the other hand, dystonia and paratonia also manifest as abnormalities of muscle tone, but arise more due to the network dysfunction between the basal ganglia and the thalamo-cerebello-cortical connections. In this review, we have discussed the normal homeostatic mechanisms maintaining tone and the pathophysiology of spasticity and rigidity with its anatomical correlates. Thereafter, we have also highlighted the phenomenon of network dysfunction, cortical disinhibition, and neuroplastic alterations giving rise to dystonia and paratonia.
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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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McCambridge AB, Bradnam LV. Cortical neurophysiology of primary isolated dystonia and non-dystonic adults: A meta-analysis. Eur J Neurosci 2020; 53:1300-1323. [PMID: 32991762 DOI: 10.1111/ejn.14987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive method to assess neurophysiology of the primary motor cortex in humans. Dystonia is a poorly understood neurological movement disorder, often presenting in an idiopathic, isolated form across different parts of the body. The neurophysiological profile of isolated dystonia compared to healthy adults remains unclear. We conducted a systematic review with meta-analysis of neurophysiologic TMS measures in people with isolated dystonia to provide a synthesized understanding of cortical neurophysiology associated with isolated dystonia. We performed a systematic database search and data were extracted independently by the two authors. Separate meta-analyses were performed for TMS measures of: motor threshold, corticomotor excitability, short interval intracortical inhibition, cortical silent period, intracortical facilitation and afferent-induced inhibition. Standardized mean differences were calculated using a random effects model to determine overall effect sizes and confidence intervals. Heterogeneity was explored using dystonia type subgroup analysis. The search resulted in 78 studies meeting inclusion criteria, of these 57 studies reported data in participants with focal hand dystonia, cervical dystonia, blepharospasm or spasmodic dysphonia, and were included in at least one meta-analysis. The cortical silent period, short-interval intracortical inhibition and afferent-induced inhibition was found to be reduced in isolated dystonia compared to controls. Reduced GABAergic-mediated inhibition in the primary motor cortex in idiopathic isolated dystonia's suggest interventions targeted to aberrant cortical disinhibition could provide a novel treatment. Future meta-analyses require neurophysiology studies to use homogeneous cohorts of isolated dystonia participants, publish raw data values, and record electromyographic responses from dystonic musculature where possible.
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Affiliation(s)
- Alana B McCambridge
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, NSW, Australia
| | - Lynley V Bradnam
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
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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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Summers RLS, Chen M, MacKinnon CD, Kimberley TJ. Evidence for normal intracortical inhibitory recruitment properties in cervical dystonia. Clin Neurophysiol 2020; 131:1272-1279. [PMID: 32304844 DOI: 10.1016/j.clinph.2020.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Dystonia is associated with reduced intracortical inhibition as measured by the cortical silent period (cSP); however, this may be due to abnormal cSP threshold or input-output properties. This study evaluated cSP recruitment properties in people with cervical dystonia (CD). METHODS Bilateral electromyographic recordings were collected in the upper trapezius muscle in response to transcranial magnetic stimulation of the left and right primary motor cortex in a group with CD (n = 19) and controls (n = 21). cSP threshold, cSP input-output properties at stimulation intensities from 1 to 1.4x the cSP threshold, ipsilateral silent period duration (iSP) and timing and magnitude of the contralateral and ipsilateral motor evoked potential (MEP) were assessed. RESULTS The cSP threshold, input-output properties, and contralateral MEP magnitude were not significantly different between groups (all p > 0.07). Hemispheric symmetry was present in the control group while the CD group had reduced iSP (p < 0.01) and a trend for reduced ipsilateral MEP response (p = 0.053) in the left hemisphere. CONCLUSIONS Recruitment properties of intracortical inhibition are similar between control and CD groups. Transcallosal inhibition is asymmetric between hemispheres in people with CD. SIGNIFICANCE Evidence of normal intracortical inhibition recruitment properties challenge the commonly held view that cortical inhibition is reduced in dystonia.
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Affiliation(s)
- Rebekah L S Summers
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, 426 Church St. SE, Minneapolis, MN 55455, USA; Department of Neurology, School of Medicine, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - Mo Chen
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, 426 Church St. SE, Minneapolis, MN 55455, USA; Non-invasive Neuromodulation Laboratory, MnDRIVE Initiative, University of Minnesota, 247, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Colum D MacKinnon
- Department of Neurology, School of Medicine, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Teresa J Kimberley
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, 426 Church St. SE, Minneapolis, MN 55455, USA; School of Health and Rehabilitation Sciences, Department of Physical Therapy, Massachusetts General Hospital, Institute of Health Professions, 36 First Ave, Boston, MA 02129, USA
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Turco CV, Fassett HJ, Locke MB, El-Sayes J, Nelson AJ. Parallel modulation of interhemispheric inhibition and the size of a cortical hand muscle representation during active contraction. J Neurophysiol 2019; 122:368-377. [PMID: 31116626 DOI: 10.1152/jn.00030.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Interhemispheric inhibition (IHI) between motor cortexes is thought to suppress unwanted mirror movements during voluntary behaviors and can be assessed using paired-pulse transcranial magnetic stimulation (TMS). The magnitude of IHI may be related to the size of the cortical representation for a given muscle as a mechanism for facilitating unimanual control. To date, the relationship between IHI and cortical muscle representations remains unknown. Fifteen healthy, right-handed individuals participated in the present study. IHI was examined in the right first dorsal interosseous (FDI) muscle by delivering conditioning TMS to ipsilateral (right) primary motor cortex (M1) followed by a test TMS pulse to contralateral (left) M1. The size of the FDI representation in M1 was determined by delivering suprathreshold TMS over a 5 × 5-cm grid centered on the FDI motor hotspot of the left M1. Both IHI and cortical territory were obtained during three conditions: rest, contralateral (right) FDI contraction, and ipsilateral (left) FDI contraction. Results indicate a significant association between IHI and the size of the FDI representation only in the context of contraction and not when the FDI muscle was relaxed. Specifically, reduced IHI corresponded to larger cortical FDI representations during both contralateral and ipsilateral contraction. These data demonstrate that, for a muscle of the hand, the magnitude of IHI and the cortical territory are associated within the context of muscle contraction. NEW & NOTEWORTHY This study provides evidence from noninvasive brain stimulation that communication between the motor cortexes of the two hemispheres plays a role in shaping the motor cortical map that outputs to a hand muscle during active contraction of that muscle. This relationship exists only when the hand muscle is contracted. The findings presented further our understanding of motor control during unilateral movement and may inform future research targeting clinical populations that exhibit impaired unilateral control.
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Affiliation(s)
- Claudia V Turco
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Hunter J Fassett
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Mitchell B Locke
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Jenin El-Sayes
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
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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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He JL, Fuelscher I, Enticott PG, Teo WP, Barhoun P, Hyde C. Interhemispheric Cortical Inhibition Is Reduced in Young Adults With Developmental Coordination Disorder. Front Neurol 2018; 9:179. [PMID: 29628909 PMCID: PMC5876243 DOI: 10.3389/fneur.2018.00179] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/07/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction While the etiology of developmental coordination disorder (DCD) is yet to be established, brain-behavior modeling provides a cogent argument that neuropathology may subserve the motor difficulties typical of DCD. We argue that a number of the core behavioral features of the DCD profile (such as poor surround inhibition, compromised motor inhibition, and the presence of mirror movements) are consistent with difficulties regulating inhibition within the primary motor cortex (M1). This study aimed to be the first account of the integrity of cortical inhibition in motor cortices in DCD. Method The sample consisted of eight adults with DCD aged (18–30 years) and 10 aged matched neurotypical controls. Participants received a common battery of single and paired-pulse transcranial magnetic stimulation from which a series of neurophysiological measures classically used to measure intra- [e.g., short-interval cortical inhibition (SICI), long-interval cortical inhibition (LICI), and cortical silent period] and inter hemispheric [e.g., ipsilateral silent period (ISP)] cortical inhibition of the M1 at rest were recorded. Results While no group differences were observed for any measure of intrahemispheric cortical inhibition, individuals with DCD demonstrated significantly reduced interhemispheric cortical inhibition relative to controls, shown by consistently lower ISPratios. Conclusion Our findings are consistent with the view that regulation of cortical inhibition of M1 activity may be atypical in individuals with DCD, indicating differential GABAergic operation. This effect, however, appears to be select to cortical inhibition. Importantly, our data support the notion that reduced interhemispheric M1 cortical inhibition may at least partly explain commonly reported difficulties with bimanual motor control in DCD. The neurochemical implications and limitations of this evidence will be discussed.
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Affiliation(s)
- Jason L He
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Ian Fuelscher
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Peter G Enticott
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Wei-Peng Teo
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Pamela Barhoun
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Christian Hyde
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
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Kishore A, Popa T, James P, Krishnan S, Robert S, Meunier S. Severity of Writer’s Cramp is Related to Faulty Motor Preparation. Cereb Cortex 2017; 28:3564-3577. [DOI: 10.1093/cercor/bhx228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 08/15/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Asha Kishore
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Traian Popa
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Praveen James
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Syam Krishnan
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Sunitha Robert
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Sabine Meunier
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
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Iscan Z, Nazarova M, Fedele T, Blagovechtchenski E, Nikulin VV. Pre-stimulus Alpha Oscillations and Inter-subject Variability of Motor Evoked Potentials in Single- and Paired-Pulse TMS Paradigms. Front Hum Neurosci 2016; 10:504. [PMID: 27774060 PMCID: PMC5054042 DOI: 10.3389/fnhum.2016.00504] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/26/2016] [Indexed: 12/17/2022] Open
Abstract
Inter- and intra-subject variability of the motor evoked potentials (MEPs) to TMS is a well-known phenomenon. Although a possible link between this variability and ongoing brain oscillations was demonstrated, the results of the studies are not consistent with each other. Exploring this topic further is important since the modulation of MEPs provides unique possibility to relate oscillatory cortical phenomena to the state of the motor cortex probed with TMS. Given that alpha oscillations were shown to reflect cortical excitability, we hypothesized that their power and variability might explain the modulation of subject-specific MEPs to single- and paired-pulse TMS (spTMS, ppTMS, respectively). Neuronal activity was recorded with multichannel electroencephalogram. We used spTMS and two ppTMS conditions: intracortical facilitation (ICF) and short-interval intracortical inhibition (SICI). Spearman correlations were calculated within and across subjects between MEPs and the pre-stimulus power of alpha oscillations in low (8-10 Hz) and high (10-12 Hz) frequency bands. Coefficient of quartile variation was used to measure variability. Across-subject analysis revealed no difference in the pre-stimulus alpha power among the TMS conditions. However, the variability of high-alpha power in spTMS condition was larger than in the SICI condition. In ICF condition pre-stimulus high-alpha power variability correlated positively with MEP amplitude variability. No correlation has been observed between the pre-stimulus alpha power and MEP responses in any of the conditions. Our results show that the variability of the alpha oscillations can be more predictive of TMS effects than the commonly used power of oscillations and we provide further support for the dissociation of high and low-alpha bands in predicting responses produced by the stimulation of the motor cortex.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University Higher School of Economics Moscow, Russia
| | - Maria Nazarova
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Research Center of NeurologyMoscow, Russia
| | - Tommaso Fedele
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Department of Neurosurgery, University Hospital of Zurich, University of ZurichZurich, Switzerland
| | - Evgeny Blagovechtchenski
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Laboratory of Neuroscience and Molecular Pharmacology, Institute of Translational Biomedicine, Saint Petersburg State UniversitySaint Petersburg, Russia
| | - Vadim V Nikulin
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Neurophysics Group, Department of Neurology, Charité - University Medicine BerlinBerlin, Germany
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Abnormal interhemispheric inhibition in musician's dystonia - Trait or state? Parkinsonism Relat Disord 2016; 25:33-8. [PMID: 26923523 DOI: 10.1016/j.parkreldis.2016.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/11/2016] [Accepted: 02/17/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION A clustering of relatives with dystonia has been reported in families with musician's dystonia suggesting a genetic contribution to this disease. The aim of the present study was to determine whether interhemispheric inhibition (IHI) measured with transcranial magnetic stimulation is impaired in healthy family members rendering it a suitable endophenotypic marker for musician's dystonia. METHODS Patients with musician's hand dystonia (n = 21), patients with sporadic writer's cramp (n = 15), their healthy family members (n = 27), healthy musicians (n = 12) and healthy non-musicians (n = 12) were included. An extended interview about the family history and musical activity was performed. IHI in both hemispheres was measured using transcranial magnetic stimulation. RESULTS A stepwise regression analysis revealed musical activity (p = 0.001) and a family history of dystonia (p = 0.008) but not dystonia per se, age, handedness or gender as relevant factors modulating IHI. CONCLUSION These data support the notion of a genetic background of musician's hand dystonia and suggests that reduced IHI is a possible endophenotypic marker of this disorder.
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Abstract
Writer's cramp is the most common form of focal, task-specific dystonia. Symptoms frequently evolve in the setting of repetitive hand movements and increased writing demands, and clinical presentations demonstrate a variety of different dystonic patterns of the upper extremity such as while writing or holding a writing utensil. However, why writer's cramp develops still remains much of a mystery. Clinical evaluation of patients with writer's cramp and various theories regarding its pathophysiology are reviewed. Treatment can be challenging and often involves a combination of pharmacologic (e.g., oral medications, botulinum toxin injections) and non-pharmacologic approaches (e.g., neurosurgical or neurostimulatory interventions, rehabilitation therapies, adaptive devices). Management strategies for writer's cramp using both of these approaches will be discussed.
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Affiliation(s)
- Jennifer G Goldman
- Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, USA.
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23
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Kukke SN, de Campos AC, Damiano D, Alter KE, Patronas N, Hallett M. Cortical activation and inter-hemispheric sensorimotor coherence in individuals with arm dystonia due to childhood stroke. Clin Neurophysiol 2014; 126:1589-98. [PMID: 25499610 DOI: 10.1016/j.clinph.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/04/2014] [Accepted: 11/05/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Dystonia is a disabling motor disorder often without effective therapies. To better understand the genesis of dystonia after childhood stroke, we analyzed electroencephalographic (EEG) recordings in this population. METHODS Resting spectral power of EEG signals over bilateral sensorimotor cortices (Powrest), resting inter-hemispheric sensorimotor coherence (Cohrest), and task-related changes in power (TRPow) and coherence (TRCoh) during wrist extension were analyzed in individuals with dystonia (age 20±3years) and healthy volunteers (age 17±5years). RESULTS Ipsilesional TRPow decrease was significantly lower in patients than controls during the more affected wrist task. Force deficits of the affected wrist correlated with reduced alpha TRPow decrease on the ipsilesional and not the contralesional hemisphere. Cohrest was significantly lower in patients than controls, and correlated with more severe dystonia and poorer hand function. Powrest and TRCoh were similar between groups. CONCLUSIONS The association between weakness and cortical activation during wrist extension highlights the importance of ipsilesional sensorimotor activation on function. Reduction of Cohrest in patients reflects a loss of inter-hemispheric connectivity that may result from structural changes and neuroplasticity, potentially contributing to the development of dystonia. SIGNIFICANCE Cortical and motor dysfunction are correlated in patients with childhood stroke and may in part explain the genesis of dystonia.
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Affiliation(s)
- Sahana N Kukke
- Biomedical Engineering Department, The Catholic University of America, USA; Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA; National Institute of Neurological Disorders and Stroke, National Institutes of Health, USA
| | | | - Diane Damiano
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA
| | - Katharine E Alter
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA; Mount Washington Pediatric Hospital, USA
| | - Nicholas Patronas
- Radiology Department, National Institutes of Health Clinical Center, USA
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, USA.
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Bank PJ, Peper C(LE, Marinus J, Beek PJ, van Hilten JJ. Evaluation of mirrored muscle activity in patients with Complex Regional Pain Syndrome. Clin Neurophysiol 2014; 125:2100-8. [DOI: 10.1016/j.clinph.2014.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/19/2014] [Accepted: 02/19/2014] [Indexed: 11/30/2022]
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Perruchoud D, Murray MM, Lefebvre J, Ionta S. Focal dystonia and the Sensory-Motor Integrative Loop for Enacting (SMILE). Front Hum Neurosci 2014; 8:458. [PMID: 24999327 PMCID: PMC4064702 DOI: 10.3389/fnhum.2014.00458] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 06/04/2014] [Indexed: 12/12/2022] Open
Abstract
Performing accurate movements requires preparation, execution, and monitoring mechanisms. The first two are coded by the motor system, the latter by the sensory system. To provide an adaptive neural basis to overt behaviors, motor and sensory information has to be properly integrated in a reciprocal feedback loop. Abnormalities in this sensory-motor loop are involved in movement disorders such as focal dystonia, a hyperkinetic alteration affecting only a specific body part and characterized by sensory and motor deficits in the absence of basic motor impairments. Despite the fundamental impact of sensory-motor integration mechanisms on daily life, the general principles of healthy and pathological anatomic–functional organization of sensory-motor integration remain to be clarified. Based on the available data from experimental psychology, neurophysiology, and neuroimaging, we propose a bio-computational model of sensory-motor integration: the Sensory-Motor Integrative Loop for Enacting (SMILE). Aiming at direct therapeutic implementations and with the final target of implementing novel intervention protocols for motor rehabilitation, our main goal is to provide the information necessary for further validating the SMILE model. By translating neuroscientific hypotheses into empirical investigations and clinically relevant questions, the prediction based on the SMILE model can be further extended to other pathological conditions characterized by impaired sensory-motor integration.
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Affiliation(s)
- David Perruchoud
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne Lausanne, Switzerland
| | - Micah M Murray
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne Lausanne, Switzerland ; The Electroencephalography Brain Mapping Core, Center for Biomedical Imaging Lausanne, Switzerland
| | - Jeremie Lefebvre
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne Lausanne, Switzerland
| | - Silvio Ionta
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne Lausanne, Switzerland
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Frucht SJ. The definition of dystonia: current concepts and controversies. Mov Disord 2014; 28:884-8. [PMID: 23893444 DOI: 10.1002/mds.25529] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 04/17/2013] [Accepted: 05/02/2013] [Indexed: 11/07/2022] Open
Abstract
The definition of dystonia has been a subject of much debate and controversy for the last century. In this paper, a practical definition of dystonia for the movement disorders expert is presented, based on a new algorithm. © 2013 Movement Disorder Society.
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Affiliation(s)
- Steven J Frucht
- Department of Neurology, Mount Sinai Medical Center, New York, NY 10029, USA.
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27
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Sattler V, Dickler M, Michaud M, Meunier S, Simonetta-Moreau M. Does abnormal interhemispheric inhibition play a role in mirror dystonia? Mov Disord 2013; 29:787-96. [PMID: 24352854 DOI: 10.1002/mds.25768] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 11/06/2013] [Accepted: 11/06/2013] [Indexed: 11/07/2022] Open
Abstract
The presence of mirror dystonia (dystonic movement induced by a specific task performed by the unaffected hand) in the dominant hand of writer's cramp patients when the nondominant hand is moved suggests an abnormal interaction between the 2 hemispheres. In this study we compare the level of interhemispheric inhibition (IHI) in 2 groups of patients with writer's cramp, one with the presence of a mirror dystonia and the other without as well as a control group. The level of bidirectional IHI was measured in wrist muscles with dual-site transcranial magnetic stimulation with a 10-millisecond (short IHI) and a 40-millisecond (long IHI) interstimulus interval during rest and while holding a pen in 9 patients with mirror dystonia 7 without mirror dystonia, and 13 controls. The group of patients without mirror dystonia did not differ from the controls in their IHI level. In contrast, IHI was significantly decreased in the group of patients with mirror dystonia in comparison with the group without mirror dystonia and the controls in both wrist muscles of both the dystonic and unaffected hand whatever the resting or active condition (P = 0.001). The decrease of IHI level in the group of patients with mirror dystonia was negatively correlated with the severity and the duration of the disease: the weaker the level of IHI, the more severe was the disease and the longer its duration. Interhemispheric inhibition disturbances are most likely involved in the occurrence of mirror dystonia. This bilateral deficient inhibition further suggests the involvement of the unaffected hemisphere in the pathophysiology of unilateral dystonia.
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Affiliation(s)
- Virginie Sattler
- Centre Hospitalier Universitaire de Toulouse, Pôle Neurosciences, CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Inserm; Imagerie cérébrale et handicaps neurologiques, UMR 825, CHU Purpan, Pavillon Baudot, Toulouse, France
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28
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Ghosh S, Mehta AR, Huang G, Gunraj C, Hoque T, Saha U, Ni Z, Chen R. Short- and long-latency interhemispheric inhibitions are additive in human motor cortex. J Neurophysiol 2013; 109:2955-62. [DOI: 10.1152/jn.00960.2012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) of the human primary motor cortex (M1) at suprathreshold strength results in inhibition of M1 in the opposite hemisphere, a process termed interhemispheric inhibition (IHI). Two phases of IHI, termed short-latency interhemispheric inhibition (SIHI) and long-latency interhemispheric inhibition (LIHI), involving separate neural circuits, have been identified. In this study we evaluated how these two inhibitory processes interact with each other. We studied 10 healthy right-handed subjects. A test stimulus (TS) was delivered to the left M1, and motor evoked potentials (MEPs) were recorded from the right first dorsal interosseous (FDI) muscle. Contralateral conditioning stimuli (CCS) were applied to the right M1 either 10 ms or 50 ms prior to the TS, inducing SIHI and LIHI, respectively, in the left M1. The effects of SIHI and LIHI alone, and SIHI and LIHI delivered together, were compared. The TS was adjusted to produce 1-mV or 0.5-mV MEPs when applied alone or after CCS. SIHI and LIHI were found to be additive when delivered together, irrespective of the strength of the TS. The interactions were affected neither by varying the strength of the conditioning stimulus producing SIHI nor by altering the current direction of the TS. Small or opposing interactions, however, may not have been detected. These results support previous findings suggesting that SIHI and LIHI act through different neural circuits. Such inhibitory processes may be used individually or additively during motor tasks and should be studied as separate processes in functional studies.
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Affiliation(s)
- Soumya Ghosh
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Arpan R. Mehta
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Guan Huang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Carolyn Gunraj
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Tasnuva Hoque
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Utpal Saha
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Zhen Ni
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Research Institute, Toronto, Ontario, Canada
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Continuous theta-burst stimulation over the primary somatosensory cortex modulates interhemispheric inhibition. Neuroreport 2013; 24:394-8. [DOI: 10.1097/wnr.0b013e32836131ca] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Rubio-Agusti I, Carecchio M, Bhatia KP, Kojovic M, Parees I, Chandrashekar HS, Footitt EJ, Burke D, Edwards MJ, Lachmann RH, Murphy E. Movement Disorders in Adult Patients With Classical Galactosemia. Mov Disord 2013; 28:804-10. [DOI: 10.1002/mds.25348] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 11/27/2012] [Accepted: 12/09/2012] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ignacio Rubio-Agusti
- Charles Dent Metabolic Unit; National Hospital for Neurology and Neurosurgery; London United Kingdom
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
- Movement Disorders Unit; Department of Neurology; Hospital Universtiari La Fe; Valencia Spain
| | - Miryam Carecchio
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
- Department of Neurology; Amedeo Avogadro University; Novara Italy
| | - Kailash P. Bhatia
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
| | - Maja Kojovic
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
- Department of Neurology; University of Ljubljana; Ljubljana Slovenia
| | - Isabel Parees
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
| | - Hoskote S. Chandrashekar
- Lysholm Department of Neuroradiology; National Hospital for Neurology and Neurosurgery; London United Kingdom
| | - Emma J. Footitt
- Clinical and Molecular Genetics Unit; UCL Institute of Child Health, Great Ormond Street Hospital; London United Kingdom
| | - Derek Burke
- Clinical and Molecular Genetics Unit; UCL Institute of Child Health, Great Ormond Street Hospital; London United Kingdom
| | - Mark J. Edwards
- Sobell Department for Movement Disorders and Clinical Neuroscience; Institute of Neurology; National Hospital for Neurology and Neurosurgery; London United Kingdom
| | - Robin H.L. Lachmann
- Charles Dent Metabolic Unit; National Hospital for Neurology and Neurosurgery; London United Kingdom
| | - Elaine Murphy
- Charles Dent Metabolic Unit; National Hospital for Neurology and Neurosurgery; London United Kingdom
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Veugen LC, Hoffland BS, Stegeman DF, van de Warrenburg BP. Inhibition of the dorsal premotor cortex does not repair surround inhibition in writer's cramp patients. Exp Brain Res 2012. [PMID: 23192337 DOI: 10.1007/s00221-012-3350-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Writer's cramp is a task-specific form of focal dystonia, characterized by abnormal movements and postures of the hand and arm during writing. Two consistent abnormalities in its pathophysiology are a loss of surround inhibition and overactivity of the dorsal premotor cortex (PMd). This study aimed to assess a possible link between these two phenomena by investigating whether PMd inhibition leads to an improvement of surround inhibition, in parallel with previously demonstrated writing improvement. Fifteen writer's cramp patients and ten controls performed a simple motor hand task during which surround inhibition was measured using transcranial magnetic stimulation. Motor cortical excitability was measured of the active and surround muscles at three phases of the task. Surround inhibition and writing performance were assessed before and after PMd inhibitory continuous theta burst stimulation. In contrast to healthy controls, patients did not show inhibition of the abductor digiti minimi muscle during movement initiation of the first dorsal interosseus muscle, confirming the loss of surround inhibition. PMd inhibition led to an improvement of writing speed in writer's cramp patients. However, in both groups, no changes in surround inhibition were observed. The results confirm a role for the PMd in the pathophysiology of writer's cramp. We show that PMd inhibition does not lead to restoration of the surround inhibition defect in writer's cramp, despite the improvement in writing. This questions the involvement of the PMd in the loss of surround inhibition, and perhaps also the direct link between surround inhibition and dystonia.
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Affiliation(s)
- Lidwien C Veugen
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
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32
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McGregor KM, Heilman KM, Nocera JR, Patten C, Manini TM, Crosson B, Butler AJ. Aging, aerobic activity and interhemispheric communication. Brain Sci 2012; 2:634-48. [PMID: 24961264 PMCID: PMC4061818 DOI: 10.3390/brainsci2040634] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 11/02/2012] [Accepted: 11/13/2012] [Indexed: 11/08/2022] Open
Abstract
Recent studies have shown that during unimanual motor tasks, aging adults show bilateral recruitment of primary motor cortex (M1), while younger adults show a suppression of the ipsilateral motor cortex. Additional work has indicated that increased bilateral M1 recruitment in older adults may be deleterious when performing some motor tasks. However, higher levels of physical fitness are associated with improved dexterity and fitness may mitigate the loss of both inhibitory and excitatory communication in aging adults. The goal of this study was to assess dexterity and interhemispheric motor communication in physically fit and sedentary middle-age (40-60 years) right handed participants using tests of hand deftness and transcranial magnetic stimulation (TMS). To behaviorally assess the influence of interhemispheric communication on motor performance, participants also perform the coin rotation deftness task while maintaining pinch force with the opposite hand (bimanual condition). We correlated these behavioral measures with the ipsilateral silent period using TMS to assess interhemispheric inhibition. Our results show that the middle-aged adults who were physically fit had better dexterity of their right hand (finger tapping and peg-board). When performing the coin rotation task the fit group had no between hand differences, but the sedentary group's left hand performance was inferior to the their right hand. We found that better dexterity correlated with ipsilateral silent period duration (greater inhibition) thereby supporting the postulate that fitness improves interhemispheric motor communication.
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Affiliation(s)
- Keith M McGregor
- Atlanta Rehabilitation Research and Development Center of Excellence, Department of Veteran's Affairs, Decatur, GA 30033, USA.
| | - Kenneth M Heilman
- Department of Veteran's Affairs Brain Rehabilitation and Research Center, Gainesville, FL 32609, USA.
| | - Joe R Nocera
- Atlanta Rehabilitation Research and Development Center of Excellence, Department of Veteran's Affairs, Decatur, GA 30033, USA.
| | - Carolynn Patten
- Department of Veteran's Affairs Brain Rehabilitation and Research Center, Gainesville, FL 32609, USA.
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32611, USA.
| | - Bruce Crosson
- Atlanta Rehabilitation Research and Development Center of Excellence, Department of Veteran's Affairs, Decatur, GA 30033, USA.
| | - Andrew J Butler
- Atlanta Rehabilitation Research and Development Center of Excellence, Department of Veteran's Affairs, Decatur, GA 30033, USA.
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33
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Interhemispheric inhibition in human wrist muscles. Exp Brain Res 2012; 221:449-58. [DOI: 10.1007/s00221-012-3187-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 07/03/2012] [Indexed: 11/25/2022]
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Poston B, Kukke SN, Paine RW, Francis S, Hallett M. Cortical silent period duration and its implications for surround inhibition of a hand muscle. Eur J Neurosci 2012; 36:2964-71. [PMID: 22775302 DOI: 10.1111/j.1460-9568.2012.08212.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Surround inhibition is a neural mechanism that assists in the focusing of excitatory drive to muscles responsible for a given movement (agonist muscles) by suppressing unwanted activity in muscles not relevant to the movement (surround muscles). The purpose of the study was to determine the contribution of γ-aminobutyric acid(B) receptor-mediated intracortical inhibition, as assessed by the cortical silent period (CSP), to the generation of surround inhibition in the motor system. Eight healthy adults (five women and three men, 29.8 ± 9 years) performed isometric contractions with the abductor digiti minimi (ADM) muscle in separate conditions with and without an index finger flexion movement. The ADM motor evoked potential amplitude and CSP duration elicited by transcranial magnetic stimulation were compared between a control condition in which the ADM was activated independently and during conditions involving three phases (pre-motor, phasic, and tonic) of the index finger flexion movement. The motor evoked potential amplitude of the ADM was greater during the control condition compared with the phasic condition. Thus, the presence of surround inhibition was confirmed in the present study. Most critically, the CSP duration of the ADM decreased during the phasic stage of finger flexion compared with the control condition, which indicated a reduction of this type of intracortical inhibition during the phasic condition. These findings indicate that γ-aminobutyric acid(B) receptor-mediated intracortical inhibition, as measured by the duration of the CSP, does not contribute to the generation of surround inhibition in hand muscles.
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Affiliation(s)
- Brach Poston
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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35
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Motor pathway excitability in ATP13A2 mutation carriers: A transcranial magnetic stimulation study. Parkinsonism Relat Disord 2012; 18:590-4. [DOI: 10.1016/j.parkreldis.2011.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 10/23/2011] [Accepted: 10/31/2011] [Indexed: 11/17/2022]
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Cox BC, Cincotta M, Espay AJ. Mirror movements in movement disorders: a review. Tremor Other Hyperkinet Mov (N Y) 2012; 2:tre-02-59-398-1. [PMID: 23440079 PMCID: PMC3569961 DOI: 10.7916/d8vq31dz] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 12/30/2011] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Mirror movements (MM) are involuntary movements of homologous muscles during voluntary movements of contralateral body regions. While subtle mirroring can be present in otherwise healthy adults, overt MM may be common in many movement disorders. Examining these collective findings may further our understanding of MM and help define their usefulness as a clinical sign. METHODS We sought to review English language research articles examining the presence, clinical significance, and/or pathophysiology of MM in Parkinson's disease (PD), corticobasal syndrome (CBS), essential tremor (ET), focal hand dystonia, Creutzfeldt-Jakob's disease (CJD), and Huntington's disease. When available, MM in these disorders were compared with those of healthy age-matched controls and congenital disorders such as Klippel-Feil syndrome and X-linked Kallman's syndrome. RESULTS Clinical presentation of MM is common in asymmetric parkinsonian disorders (early PD, CBS) and manifests differently depending on the side affected (less affected hand in PD, more affected hand in CBS, either hand in ET, and both hands in healthy adults and congenital disorders), stage of disease (early, asymmetric PD and CJD), and presence of concomitant mirror-like overflow phenomena (focal dystonia and CBS-associated alien hand). In general, uncrossed descending corticospinal projections (congenital MM) and/or abnormal activation of the motor cortex ipsilateral to the voluntary task (most acquired MM), i.e., activation of the normal crossed corticospinal pathway, are required for the generation of MM. DISCUSSION MM are common motor phenomena and present differently in several acquired (mostly neurodegenerative) and congenital movement disorders. Future studies on MM will enhance the clinical diagnosis of selected movement disorders and contribute to our understanding of the normal physiology of bimanual coordination.
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Affiliation(s)
- Benjamin C. Cox
- University of Cincinnati Neuroscience Institute, Department of Neurology, Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, United States of America
| | | | - Alberto J. Espay
- University of Cincinnati Neuroscience Institute, Department of Neurology, Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, United States of America
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Houdayer E, Beck S, Karabanov A, Poston B, Hallett M. The differential modulation of the ventral premotor-motor interaction during movement initiation is deficient in patients with focal hand dystonia. Eur J Neurosci 2012; 35:478-85. [PMID: 22288483 PMCID: PMC3270366 DOI: 10.1111/j.1460-9568.2011.07960.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A major feature of focal hand dystonia (FHD) pathophysiology is the loss of inhibition. One inhibitory process, surround inhibition, for which the cortical mechanisms are still unknown, is abnormal in FHD. As the ventral premotor cortex (PMv) plays a key role in the sensorimotor processing involved in shaping finger movements and has many projections onto the primary motor cortex (M1), we hypothesized that the PMv-M1 connections might play a role in surround inhibition. A paired-pulse transcranial magnetic stimulation paradigm was used in order to evaluate and compare the PMv-M1 interactions during different phases (rest, preparation and execution) of an index finger movement in patients with FHD and controls. A sub-threshold conditioning pulse (80% resting motor threshold) was applied to the PMv at 6 ms before M1 stimulation. The right abductor pollicis brevis, a surround muscle, was the target muscle. In healthy controls, the results showed that PMv stimulation induced an ipsilateral ventral premotor-motor inhibition at rest. This cortico-cortical interaction changed into an early facilitation (100 ms before movement onset) and turned back to inhibition 50 ms later. In patients with FHD, this PMv-M1 interaction and its modulation were absent. Our results show that, although the ipsilateral ventral premotor-motor inhibition does not play a key role in the genesis of surround inhibition, PMv has a dynamic influence on M1 excitability during the early steps of motor execution. The impaired cortico-cortical interactions observed in patients with FHD might contribute, at least in part, to the abnormal motor command.
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Affiliation(s)
- Elise Houdayer
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, 10 Center Drive MSC 1428, Building 10, Room 7D37, Bethesda, MD 20892, USA
| | - Sandra Beck
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, 10 Center Drive MSC 1428, Building 10, Room 7D37, Bethesda, MD 20892, USA
- Department of Neurology and Clinical Neurophysiology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anke Karabanov
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, 10 Center Drive MSC 1428, Building 10, Room 7D37, Bethesda, MD 20892, USA
| | - Brach Poston
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, 10 Center Drive MSC 1428, Building 10, Room 7D37, Bethesda, MD 20892, USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, 10 Center Drive MSC 1428, Building 10, Room 7D37, Bethesda, MD 20892, USA
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Thompson VB, Jinnah HA, Hess EJ. Convergent mechanisms in etiologically-diverse dystonias. Expert Opin Ther Targets 2011; 15:1387-403. [PMID: 22136648 DOI: 10.1517/14728222.2011.641533] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Dystonia is a neurological disorder associated with twisting motions and abnormal postures, which compromise normal movements and can be both painful and debilitating. It can affect a single body part (focal), several contiguous regions (segmental), or the entire body (generalized), and can arise as a result of numerous causes, both genetic and acquired. Despite the diversity of causes and manifestations, shared clinical features suggest that common mechanisms of pathogenesis may underlie many dystonias. AREAS COVERED Shared themes in etiologically-diverse dystonias exist at several biological levels. At the cellular level, abnormalities in the dopaminergic system, mitochondrial function and calcium regulation are often present. At the anatomical level, the basal ganglia and the cerebellum are frequently implicated. Global CNS dysfunction, specifically aberrant neuronal plasticity, inhibition and sensorimotor integration, are also observed in a number of dystonias. Using clinical data and data from animal models, this article seeks to highlight shared pathways that may be critical in understanding mechanisms and identifying novel therapeutic strategies in dystonia. EXPERT OPINION Identifying shared features of pathogenesis can provide insight into the biological processes that underlie etiologically diverse dystonias, and can suggest novel targets for therapeutic intervention that may be effective in a broad group of affected individuals.
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Affiliation(s)
- Valerie B Thompson
- Emory University School of Medicine, Department of Pharmacology, Woodruff Memorial Research Building, Suite 6000, 101 Woodruff Circle, Atlanta, GA 30322, USA
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Abstract
Surround inhibition is a physiological mechanism to focus neuronal activity in the central nervous system. This so-called center-surround organization is well known in sensory systems, where central signals are facilitated and eccentric signals are inhibited in order to sharpen the contrast between them. There is evidence that this mechanism is relevant to skilled motor behavior, and it is deficient, for example, in the affected primary motor cortex of patients with focal hand dystonia (FHD). While it is still not fully elucidated how surround inhibition is generated in healthy subjects, the process is enhanced with handedness and task difficulty indicating that it may be an important mechanism for the performance of individuated finger movements. In FHD, where involuntary overactivation of muscles interferes with precise finger movements, a loss of intracortical inhibition likely contributes to the loss of surround inhibition. Several intracortical inhibitory networks are modulated differently in FHD compared with healthy subjects, and these may contribute to the loss of surround inhibition. Surround inhibition can be observed and assessed in the primary motor cortex. It remains unclear, however, if the effects are created in the cortex or if they are derived from, or supported by, motor signals that come from the basal ganglia.
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40
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Neurophysiology of dystonia: The role of inhibition. Neurobiol Dis 2010; 42:177-84. [PMID: 20817092 DOI: 10.1016/j.nbd.2010.08.025] [Citation(s) in RCA: 248] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 08/12/2010] [Accepted: 08/25/2010] [Indexed: 02/03/2023] Open
Abstract
The pathophysiology of dystonia has been best studied in patients with focal hand dystonia. A loss of inhibitory function has been demonstrated at spinal, brainstem and cortical levels. Many cortical circuits seem to be involved. One consequence of the loss of inhibition is a failure of surround inhibition, and this appears to directly lead to overflow and unwanted muscle spasms. There are mild sensory abnormalities and deficits in sensorimotor integration; these also might be explained by a loss of inhibition. Increasing inhibition may be therapeutic. A possible hypothesis is that there is a genetic loss of inhibitory interneurons in dystonia and that this deficit is a substrate on which other factors can act to produce dystonia. This article is part of a Special Issue entitled "Advances in dystonia".
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Nelson AJ, Hoque T, Gunraj C, Ni Z, Chen R. Impaired interhemispheric inhibition in writer's cramp. Neurology 2010; 75:441-7. [PMID: 20679637 DOI: 10.1212/wnl.0b013e3181ebdda0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Reduced cortical inhibition is a feature of focal hand dystonia and this likely contributes to excessive muscle contractions. Inhibition from the opposite hemisphere, known as interhemispheric inhibition (IHI), was studied bidirectionally in 7 right-handed patients with writer's cramp (WC) and age-matched healthy controls in a cross-sectional physiologic study. METHODS IHI was measured with paired transcranial magnetic stimulation with the conditioning stimulus applied to the motor cortex and the test stimulus applied to the contralateral motor cortex. Surface EMG was measured in right and left first dorsal interosseous muscles during rest, and while holding a pen between the thumb and index finger at 20% maximum voluntary contraction with the right dystonia-affected hand. The time course and magnitude of IHI was studied at interstimulus intervals of 6, 8, 10, 12, 30, 40, and 50 msec between the conditioning stimulus and test stimulus. RESULTS In WC at rest, IHI was significantly reduced in the dystonia-affected right hand (IHI from right to left motor cortex) at both short (SIHI, 10-12 msec) and long (LIHI, 30-40 msec) intervals compared to the unaffected hand. Compared to controls, SIHI and LIHI were reduced in the dystonia-affected hand only. There was no difference in IHI between controls and WC during the task of holding a pen. CONCLUSIONS In WC, both SIHI and LIHI are reduced in the dystonia-affected hand compared to the unaffected hand and to healthy controls. Impaired IHI may contribute to excessive muscle contraction in WC.
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Affiliation(s)
- A J Nelson
- Division of Neurology and Krembil Neuroscience Centre, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada
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Udupa K, Ni Z, Gunraj C, Chen R. Effect of long interval interhemispheric inhibition on intracortical inhibitory and facilitatory circuits. J Physiol 2010; 588:2633-41. [PMID: 20519316 PMCID: PMC2916993 DOI: 10.1113/jphysiol.2010.189548] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 05/28/2010] [Indexed: 11/08/2022] Open
Abstract
Stimulation of the primary motor cortex (M1) of one hemisphere of the brain inhibits the opposite M1, a process known as interhemispheric inhibition (IHI). An early phase of IHI peaks at about approximately 10 ms after stimulation of the opposite hemisphere and is termed short latency interhemispheric inhibition (SIHI). A later phase peaks at about 40 ms and has been termed long latency interhemispheric inhibition (LIHI). The objective of the present study is to test how LIHI interacts with cortical inhibitory and facilitatory circuits, including short interval intracortical inhibition (SICI), intracortical facilitation (ICF) and long interval intracortical inhibition (LICI). We studied 10 healthy volunteers. LIHI from right to left hemisphere was elicited by stimulating the right M1 at an interstimulus interval (ISI) of 40 ms before stimulation of the left M1. Conditioning and test stimuli to elicit SICI, ICF and LICI were given to left M1. The effects of different sizes of test motor-evoked potential (MEP amplitudes; 0.2, 1 and 2 mV) were examined for SICI, ICF, LICI and LIHI. Using paired-pulse and triple-pulse protocols, how LIHI interacts with SICI, ICF and LICI were investigated. We found SICI increased, while LICI and LIHI decreased with increasing test MEP amplitude. The presence of LIHI did not change the degree of SICI and intracortical facilitation (ICF), and their effects of these circuits were additive. On the other hand, LICI and LIHI were reduced in the presence of each other. We conclude that different sets of cortical neurons mediate LIHI, SICI, ICF and LICI. GABA(B)-mediated LICI and LIHI have inhibitory interactions with each other while LIHI has an additive effect with GABA(A)-mediated SICI.
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Affiliation(s)
- Kaviraja Udupa
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Beck S, Hallett M. Surround inhibition is modulated by task difficulty. Clin Neurophysiol 2009; 121:98-103. [PMID: 19906559 DOI: 10.1016/j.clinph.2009.09.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 09/14/2009] [Accepted: 09/16/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to further characterize surround inhibition (SI) in the primary motor cortex (M1) by comparing its magnitude and time course during a simple reaction time task (SRT) and a choice reaction time task (CRT). METHODS In both the SRT and the CRT, subjects performed the same right index finger flexion in response to an acoustic signal. For CRT, the alternative choice was a similar movement using the left index finger, as distinguished by a different tone. In both tasks, single pulse transcranial magnetic stimulation (TMS) was applied at rest, 75ms (T1) and 25ms before EMG onset (T2), and during the first peak of EMG (T3) in the right first dorsal interosseous muscle (FDI). Motor evoked potentials (MEPs) were recorded from both FDIs, which act as synergists in the task, and the right surrounding, relaxed abductor pollicis brevis muscle (APB). RESULTS For right hand movement, SI started earlier and was more pronounced for CRT compared to SRT. For left hand movement in the CRT, SI was similar to that of right hand movement. CONCLUSIONS We conclude that SI occurs earlier and stronger with increasing task difficulty. SIGNIFICANCE The timing as well as the bilateral effect of the inhibition suggests that motor areas involved in motor planning, proximate to the motor cortex, contribute to the genesis of surround inhibition.
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Affiliation(s)
- S Beck
- Human Motor Control Section, NINDS, National Institutes of Health, Bethesda, MD 20892-1428, USA
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