1
|
Giorgi V, Apostolo G, Bertelè L. Treating Dystonia in a Soccer Player Through an Integrated Rehabilitative Approach: A Case Report. J Sport Rehabil 2024; 33:365-375. [PMID: 38702050 DOI: 10.1123/jsr.2023-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 02/24/2024] [Accepted: 03/19/2024] [Indexed: 05/06/2024]
Abstract
CONTEXT Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete's ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined. CASE PRESENTATION We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely. MANAGEMENT AND OUTCOMES An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer. CONCLUSIONS This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.
Collapse
Affiliation(s)
- Valeria Giorgi
- Rehabilitation Center, Apostolo Foundation, Merate, Italy
- Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Lugano, Switzerland
| | | | - Laura Bertelè
- Rehabilitation Center, Apostolo Foundation, Merate, Italy
| |
Collapse
|
2
|
Luo Y, Liu H, Zhong L, Weng A, Yang Z, Zhang Y, Zhang J, He X, Ou Z, Yan Z, Cheng Q, Fan X, Zhang X, Zhang W, Hu Q, Peng K, Liu G, Xu J. Regional structural abnormalities in thalamus in idiopathic cervical dystonia. BMC Neurol 2024; 24:174. [PMID: 38789945 PMCID: PMC11127434 DOI: 10.1186/s12883-024-03680-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The thalamus has a central role in the pathophysiology of idiopathic cervical dystonia (iCD); however, the nature of alterations occurring within this structure remain largely elusive. Using a structural magnetic resonance imaging (MRI) approach, we examined whether abnormalities differ across thalamic subregions/nuclei in patients with iCD. METHODS Structural MRI data were collected from 37 patients with iCD and 37 healthy controls (HCs). Automatic parcellation of 25 thalamic nuclei in each hemisphere was performed based on the FreeSurfer program. Differences in thalamic nuclei volumes between groups and their relationships with clinical information were analysed in patients with iCD. RESULTS Compared to HCs, a significant reduction in thalamic nuclei volume primarily in central medial, centromedian, lateral geniculate, medial geniculate, medial ventral, paracentral, parafascicular, paratenial, and ventromedial nuclei was found in patients with iCD (P < 0.05, false discovery rate corrected). However, no statistically significant correlations were observed between altered thalamic nuclei volumes and clinical characteristics in iCD group. CONCLUSION This study highlights the neurobiological mechanisms of iCD related to thalamic volume changes.
Collapse
Grants
- 62006220, 81771137, 82271300, and 81971103 National Natural Science Foundation of China
- 62006220, 81771137, 82271300, and 81971103 National Natural Science Foundation of China
- 62006220, 81771137, 82271300, and 81971103 National Natural Science Foundation of China
- 2023A1515012739, 2016A030310132, and 2021A1515010600 Natural Science Foundation of Guangdong Province
- 2023A1515012739, 2016A030310132, and 2021A1515010600 Natural Science Foundation of Guangdong Province
- 2023B03J0466 Science and Technology Program of Guangzhou
- 2020B1212060017 Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases
- 2018B030335001, 2023A1515012739 Guangdong Key Project
- 2015B050501003 and 2020A0505020004 Southern China International Cooperation Base for Early Intervention and Functional Rehabilitation of Neurological Diseases
- JCYJ20200109114816594 Shenzhen Science and Technology Research Program
- 202007030002 Guangzhou Key Project
- Guangdong Provincial Engineering Center for Major Neurological Disease Treatment
- Guangdong Provincial Translational Medicine Innovation Platform for Diagnosis and Treatment of Major Neurological Disease
Collapse
Affiliation(s)
- Yuhan Luo
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Huiming Liu
- Department of Medical Imaging, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Linchang Zhong
- Department of Medical Imaging, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Ai Weng
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhengkun Yang
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yue Zhang
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiana Zhang
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiuye He
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zilin Ou
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhicong Yan
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qinxiu Cheng
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xinxin Fan
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiaodong Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Weixi Zhang
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Kangqiang Peng
- Department of Medical Imaging, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Gang Liu
- Department of Neurology, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| |
Collapse
|
3
|
Sedov A, Joshi P, Semenova U, Usova S, Asriyants S, Gamaleya A, Tomskiy A, Jinnah HA, Shaikh AG. Proprioceptive Modulation of Pallidal Physiology in Cervical Dystonia. Mov Disord 2023; 38:2094-2102. [PMID: 37702261 DOI: 10.1002/mds.29603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND There is a growing body of evidence suggesting that botulinum toxin can alter proprioceptive feedback and modulate the muscle-spindle output for the treatment of dystonia. However, the mechanism for this modulation remains unclear. METHODS We conducted a study involving 17 patients with cervical dystonia (CD), seven of whom had prominent CD and 10 with generalized dystonia (GD) along with CD. We investigated the effects of neck vibration, a form of proprioceptive modulation, on spontaneous single-neuron responses and local field potentials (LFPs) recorded from the globus pallidum externus (GPe) and internus (GPi). RESULTS Our findings demonstrated that neck vibration notably increased the regularity of neck-sensitive GPi neurons in focal CD patients. Additionally, in patients with GD and CD, the vibration enhanced the firing regularity of non-neck-sensitive neurons. These effects on single-unit activity were also mirrored in ensemble responses measured through LFPs. Notably, the LFP modulation was particularly pronounced in areas populated with burst neurons compared to pause or tonic cells. CONCLUSION The results from our study emphasize the significance of burst neurons in the pathogenesis of dystonia and in the efficacy of proprioceptive modulation for its treatment. Moreover, we observed that the effects of vibration on focal CD were prominent in the α band LFP, indicating modulation of pallido-cerebellar connectivity. Moreover, the pallidal effects of vibration in GD with CD involved modulation of cerebro-pallidal θ band connectivity. Our analysis provides insight into how vibration-induced changes in pallidal activity are integrated into the downstream motor circuit. © 2023 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Alexey Sedov
- N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
- Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russia
| | - Prajakta Joshi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ulia Semenova
- N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Svetlana Usova
- N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Svetlana Asriyants
- N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, Russia
- Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Anna Gamaleya
- Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Alexey Tomskiy
- Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Hyder A Jinnah
- Department of Neurology, Pediatrics, and Genetics, Emory University, Atlanta, Georgia, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA
- Neurological Institute, University Hospitals, Cleveland, Ohio, USA
- Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
| |
Collapse
|
4
|
Bleton JP, Sangla S, Portero R, Garric D, Guiraud V, Portero P, Brandel JP, Vidailhet M, Mesure S. Repositioning errors of the head in straight-ahead position in cervical dystonia: Influence of clinical features and movement planes. Ann Phys Rehabil Med 2023; 66:101753. [PMID: 37276774 DOI: 10.1016/j.rehab.2023.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 06/07/2023]
Affiliation(s)
- Jean-Pierre Bleton
- Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France; Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.
| | - Sophie Sangla
- Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Raphaël Portero
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Dominique Garric
- BIOTN, Bioengineering, Tissues and Neuroplasticity, EA 7377, Paris-Est Créteil University, F-94010 Créteil, France
| | - Vincent Guiraud
- Université Paris Descartes, Sorbonne Paris Cité, DHU Neurovasc, INSERM U894, Service de Neurologie et Unité Neurovasculaire, Hôpital Sainte-Anne, Paris, France
| | - Pierre Portero
- BIOTN, Bioengineering, Tissues and Neuroplasticity, EA 7377, Paris-Est Créteil University, F-94010 Créteil, France
| | | | - Marie Vidailhet
- Sorbonne Université, F-75005 Paris; Inserm U1127, CNRS UMR 7225, UM 75, ICM, F75013 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France,; Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, F-75013 Paris, France
| | - Serge Mesure
- Aix-Marseille University, CNRS, ISM UMR 7287, F-13288 Marseille, France
| |
Collapse
|
5
|
Romano M, Bagnato S, Altavista MC, Avanzino L, Belvisi D, Bologna M, Bono F, Carecchio M, Castagna A, Ceravolo R, Conte A, Cosentino G, Eleopra R, Ercoli T, Esposito M, Fabbrini G, Ferrazzano G, Lalli S, Mascia MM, Osio M, Pellicciari R, Petrucci S, Valente EM, Valentino F, Zappia M, Zibetti M, Girlanda P, Tinazzi M, Defazio G, Berardelli A. Diagnostic and therapeutic recommendations in adult dystonia: a joint document by the Italian Society of Neurology, the Italian Academy for the Study of Parkinson’s Disease and Movement Disorders, and the Italian Network on Botulinum Toxin. Neurol Sci 2022; 43:6929-6945. [DOI: 10.1007/s10072-022-06424-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
|
6
|
Vittersø AD, Halicka M, Buckingham G, Proulx MJ, Bultitude JH. The sensorimotor theory of pathological pain revisited. Neurosci Biobehav Rev 2022; 139:104735. [PMID: 35705110 DOI: 10.1016/j.neubiorev.2022.104735] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/13/2022] [Accepted: 06/07/2022] [Indexed: 01/31/2023]
Abstract
Harris (1999) proposed that pain can arise in the absence of tissue damage because changes in the cortical representation of the painful body part lead to incongruences between motor intention and sensory feedback. This idea, subsequently termed the sensorimotor theory of pain, has formed the basis for novel treatments for pathological pain. Here we review the evidence that people with pathological pain have changes to processes contributing to sensorimotor function: motor function, sensory feedback, cognitive representations of the body and its surrounding space, multisensory processing, and sensorimotor integration. Changes to sensorimotor processing are most evident in the form of motor deficits, sensory changes, and body representations distortions, and for Complex Regional Pain Syndrome (CRPS), fibromyalgia, and low back pain. Many sensorimotor changes are related to cortical processing, pain, and other clinical characteristics. However, there is very limited evidence that changes in sensorimotor processing actually lead to pain. We therefore propose that the theory is more appropriate for understanding why pain persists rather than how it arises.
Collapse
Affiliation(s)
- Axel D Vittersø
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom; Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom; Department of Psychology, Oslo New University College, Oslo, Norway.
| | - Monika Halicka
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
| | - Gavin Buckingham
- Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, Somerset, United Kingdom; Centre for Real and Virtual Environments Augmentation Labs, Department of Computer Science, University of Bath, Bath, Somerset, United Kingdom
| | - Janet H Bultitude
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
| |
Collapse
|
7
|
Zeuner KE, Knutzen A, Granert O, Trampenau L, Baumann A, Wolff S, Jansen O, van Eimeren T, Kuhtz-Buschbeck JP. Never too little: Grip and lift forces following probabilistic weight cues in patients with writer's cramp. Clin Neurophysiol 2021; 132:2937-2947. [PMID: 34715418 DOI: 10.1016/j.clinph.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/03/2021] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Planning of voluntary object-related movements requires the estimation of the most probable object properties. We investigated how 14 writer's cramp (WC) patients compared to 14 controls use probabilistic weight cues in a serial grip-lift task. METHODS In every grip-lift trial, an object of either light, medium or heavy weight had to be grasped and lifted after a visual cue gave a probabilistic prediction of the object weights (e.g. 32.5% light, 67.5% medium, 0 % heavy). We determined peak (1) grip force GF, (2) load force LF, (3) grip force rate GFR, (4) load force rate LFR, while we registered brain activity with functional magnetic resonance imaging. RESULTS In both groups, GFR, LFR and GF increased when a higher probability of heavy weights was announced. When a higher probability of light weights was indicated, controls reduced GFR, LFR and GF, while WC patients did not downscale their forces. There were no inter-group differences in blood oxygenation level dependent activation. CONCLUSIONS WC patients could not utilize the decision range in motor planning and adjust their force in a probabilistic cued fine motor task. SIGNIFICANCE The results support the pathophysiological model of a hyperfunctional dopamine dependent direct basal ganglia pathway in WC.
Collapse
Affiliation(s)
| | - Arne Knutzen
- Department of Neurology, Kiel University, Germany
| | | | | | | | - Stephan Wolff
- Department of Radiology and Neuroradiology, Kiel University, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, Kiel University, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University Hospital Cologne, Germany
| | | |
Collapse
|
8
|
Ma LY, Wang ZJ, Ma HZ, Feng T. Hyper- and hypo-connectivity in sensorimotor network of drug-naïve patients with cervical dystonia. Parkinsonism Relat Disord 2021; 90:15-20. [PMID: 34340003 DOI: 10.1016/j.parkreldis.2021.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/30/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cervical dystonia (CD) is the most common form of focal dystonia with involuntary movements and postures of the head. The pathogenesis and neural mechanisms underlying CD have not been fully elucidated. METHODS Twenty-seven newly drug-naïve patients with CD and 21 healthy controls (HCs) were recruited with clinical assessment and resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Severity of CD was measured by Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tsui scores. Whole-brain voxel-wise intrinsic connectivity (IC) and seed-based functional connectivity (FC) analyses were performed for detection of changes in the CD group relative to HCs, controlling for age, gender, and global time series correlation, followed by correlation analyses of IC, seed-based FC and clinically relevant features, respectively. RESULTS In comparison with HCs, CD patients showed significantly increased IC measurement in the anterior part of the left supramarginal gyrus and extended to the inferior left postcentral gyrus (AL-SMG/IL-PCG). With this cluster as a seed, decreased FC was found in the right precentral and postcentral gyrus. Moreover, the regional IC value in the AL-SMG/IL-PCG was significantly positively correlated with TWSTRS-1 (severity) score, and significantly negatively correlated with the associated seed-based FC strength. CONCLUSIONS Our results showed signs of both hyper- and hypo-connectivity in bilateral regions of the sensorimotor network related to CD. The imbalance of functional connectivity (both hyper- and hypo-) may hint both overloading and disrupted somatosensory or sensorimotor integration dysfunction within the sensorimotor network underlying the pathophysiology of CD, thus providing a network target for future therapies.
Collapse
Affiliation(s)
- Ling-Yan Ma
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhi-Jiang Wang
- Peking University Sixth Hospital (Institute of Mental Health), Beijing, China; NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China; National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hui-Zi Ma
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Parkinson's Disease Center, Beijing Institute for Brain Disorders, Beijing, China.
| |
Collapse
|
9
|
Vallinoja J, Jaatela J, Nurmi T, Piitulainen H. Gating Patterns to Proprioceptive Stimulation in Various Cortical Areas: An MEG Study in Children and Adults using Spatial ICA. Cereb Cortex 2021; 31:1523-1537. [PMID: 33140082 PMCID: PMC7869097 DOI: 10.1093/cercor/bhaa306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
Proprioceptive paired-stimulus paradigm was used for 30 children (10-17 years) and 21 adult (25-45 years) volunteers in magnetoencephalography (MEG). Their right index finger was moved twice with 500-ms interval every 4 ± 25 s (repeated 100 times) using a pneumatic-movement actuator. Spatial-independent component analysis (ICA) was applied to identify stimulus-related components from MEG cortical responses. Clustering was used to identify spatiotemporally consistent components across subjects. We found a consistent primary response in the primary somatosensory (SI) cortex with similar gating ratios of 0.72 and 0.69 for the children and adults, respectively. Secondary responses with similar transient gating behavior were centered bilaterally in proximity of the lateral sulcus. Delayed and prolonged responses with strong gating were found in the frontal and parietal cortices possibly corresponding to larger processing network of somatosensory afference. No significant correlation between age and gating ratio was found. We confirmed that cortical gating to proprioceptive stimuli is comparable to other somatosensory and auditory domains, and between children and adults. Gating occurred broadly beyond SI cortex. Spatial ICA revealed several consistent response patterns in various cortical regions which would have been challenging to detect with more commonly applied equivalent current dipole or distributed source estimates.
Collapse
Affiliation(s)
- Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 00076 Espoo, Finland
| | - Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 00076 Espoo, Finland
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 00076 Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 00076 Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
- Aalto NeuroImaging, MEG Core, Aalto University School of Science, 00076 Espoo, Finland
| |
Collapse
|
10
|
Ferrazzano G, Berardelli I, Belvisi D, De Bartolo MI, Di Vita A, Conte A, Fabbrini G. Awareness of Dystonic Posture in Patients With Cervical Dystonia. Front Psychol 2020; 11:1434. [PMID: 32655462 PMCID: PMC7324713 DOI: 10.3389/fpsyg.2020.01434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background Cervical dystonia (CD) is a focal dystonia characterized by sensorimotor integration abnormalities and proprioceptive dysfunction. Since proprioception is essential for bodily awareness, we hypothesized that CD patients may have an impairment in dystonic posture awareness. More information on this issue could be useful to better understand whether dystonic posture affects bodily perception in CD and could help in the development of specific rehabilitation strategies based on proprioceptive input manipulation to restore bodily awareness. Objectives The aim of our study was to investigate dystonic posture and head tremor awareness in CD patients by comparing evaluations performed by CD patients with those performed by a neurologist expert in movement disorders. Methods We enrolled 25 CD patients. We investigated dystonic posture and head tremor awareness in CD patients using a standardized protocol in which patients were asked to describe the type of dystonic pattern, both while viewing standardized images of different CD subtypes (torticollis, laterocollis, anterocollis, and retrocollis) and after watching a video recording of their dystonic posture and head tremor. Results We found that 72% of CD patients correctly recognized their dystonic posture when viewing standardized images, whereas 84% of CD patients were able to identify their dystonic pattern when watching a video recording of themselves. CD patients also displayed a preserved awareness of their head tremor. We did not find any associations between dystonic pattern awareness and clinical or demographic features. Conclusion Contrary to our hypothesis, the majority of CD patients have a preserved awareness of their dystonic pattern and tremor.
Collapse
Affiliation(s)
- Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | - Antonella Di Vita
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli, Italy
| |
Collapse
|
11
|
Chu ECP, Lo FS, Bhaumik A. Secondary atlantoaxial subluxation in isolated cervical dystonia-a case report. AME Case Rep 2020; 4:9. [PMID: 32420532 DOI: 10.21037/acr.2020.03.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/28/2020] [Indexed: 12/13/2022]
Abstract
Dystonia is a neurological disorder characterized by sustained or intermittent muscle contractions resulting in twisting, repetitive movements or painful postures. Cervical dystonia (CD), an isolated dystonia of the cervical musculature, can predispose the atlantoaxial joint to unstable changes. Symptomatic treatment of dystonia through local injections of botulinum toxin clearly reduces pain in most clinical settings. However, repeated chemodenervation of the involved muscles with neurotoxin is expensive and not available to the complicated cases of CD. In this report a 14-year-old girl with a 1-year history of CD complicated by atlantoaxial subluxation was treated using chiropractic intervention. As a result of this regimen, the girl reported a significant relief from the neck pain and torticollis after the first week. More gains of cervical range of motion were made over the course of 6 months of treatment. Chiropractic might have yielded some biomechanical responses linked to clinical effects. This case demonstrates an unexpected association between CD and atlantoaxial subluxation. In cases of CDs, atlantoaxial subluxation may be ignored but requires specialized treatment. An index of suspicion should be maintained for this rare but potentially debilitating complication.
Collapse
Affiliation(s)
- Eric Chun-Pu Chu
- New York Chiropractic & Physiotherapy Centre, New York Medical Group, Hong Kong, China
| | - Fa-Sain Lo
- New York Chiropractic & Physiotherapy Centre, New York Medical Group, Hong Kong, China
| | - Amiya Bhaumik
- Faculty of Sciences, Lincoln University College, Kelantan, Malaysia
| |
Collapse
|
12
|
|
13
|
Forman CR, Svane C, Kruuse C, Gracies JM, Nielsen JB, Lorentzen J. Sustained involuntary muscle activity in cerebral palsy and stroke: same symptom, diverse mechanisms. Brain Commun 2019; 1:fcz037. [PMID: 33033798 PMCID: PMC7531180 DOI: 10.1093/braincomms/fcz037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/12/2022] Open
Abstract
Individuals with lesions of central motor pathways frequently suffer from sustained
involuntary muscle activity. This symptom shares clinical characteristics with dystonia
but is observable in individuals classified as spastic. The term spastic dystonia has been
introduced, although the underlying mechanisms of involuntary activity are not clarified
and vary between individuals depending on the disorder. This study aimed to investigate
the nature and pathophysiology of sustained involuntary muscle activity in adults with
cerebral palsy and stroke. Seventeen adults with cerebral palsy (Gross Motor Function
Classification System I–V), 8 adults with chronic stroke and 14 control individuals
participated in the study. All individuals with cerebral palsy or stroke showed increased
resistance to passive movement with Modified Ashworth Scale >1. Two-minute surface EMG
recordings were obtained from the biceps muscle during attempted rest in three positions
of the elbow joint; a maximally flexed position, a 90-degree position and a maximally
extended position. Cross-correlation analysis of sustained involuntary muscle activity
from individuals with cerebral palsy and stroke, and recordings of voluntary isometric
contractions from control individuals were performed to examine common synaptic drive. In
total, 13 out of 17 individuals with cerebral palsy and all 8 individuals with stroke
contained sustained involuntary muscle activity. In individuals with cerebral palsy, the
level of muscle activity was not affected by the joint position. In individuals with
stroke, the level of muscle activity significantly (P < 0.05)
increased from the flexed position to the 90 degree and extended position. Cumulant
density function indicated significant short-term synchronization of motor unit activities
in all recordings. All groups exhibited significant coherence in the alpha (6–15 Hz), beta
(16–35 Hz) and early gamma band (36–60 Hz). The cerebral palsy group had lower alpha band
coherence estimates, but higher gamma band coherence estimates compared with the stroke
group. Individuals with increased resistance to passive movement due to cerebral palsy or
stroke frequently suffer sustained involuntary muscle activity, which cannot exclusively
be described by spasticity. The sustained involuntary muscle activity in both groups
originated from a common synaptic input to the motor neuron pool, but the generating
mechanisms could differ between groups. In cerebral palsy it seemed to originate more from
central mechanisms, whereas peripheral mechanisms likely play a larger role in stroke. The
sustained involuntary muscle activity should not be treated simply like the spinal stretch
reflex mediated symptom of spasticity and should not either be treated identically in both
groups.
Collapse
Affiliation(s)
| | - Christian Svane
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Christina Kruuse
- Department of Neurology, Neurovascular Research Unit, Herlev Gentofte Hospital, 2730 Herlev Gentofte, Denmark
| | - Jean-Michel Gracies
- EA 7377 BIOTN, Université Paris-Est Creteil, Hospital Albert Chenevier-Henri Mondor, Service de Rééducation Neurolocomotrice, APHP, Créteil, France
| | - Jens Bo Nielsen
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.,Elsass Institute, 2830 Charlottenlund, Denmark
| | - Jakob Lorentzen
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.,Elsass Institute, 2830 Charlottenlund, Denmark
| |
Collapse
|
14
|
Nijenhuis B, Schalkwijk AHP, Hendriks S, Zutt R, Otten E, Tijssen MAJ. Skater's Cramp: A Possible Task-Specific Dystonia in Dutch Ice Skaters. Mov Disord Clin Pract 2019; 6:559-566. [PMID: 31538090 PMCID: PMC6749809 DOI: 10.1002/mdc3.12799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/03/2019] [Accepted: 05/21/2019] [Indexed: 11/30/2022] Open
Abstract
Background Skater's cramp is an involuntary lower leg movement in skilled speed skaters. We aim to evaluate whether skater's cramp is compatible with task‐specific dystonia. Methods A case‐control study tested 5 speed skaters exhibiting symptoms of skater's cramp and 5 controls. Affected skaters completed a standardized questionnaire and neurological examination. Video analyses included skating normally, intensely, and with extra mass around the skater's ankles. An Inertial Motion Capturing (IMC) device mounted on both skates provided angular velocity data for both feet. Results Median time of onset of skater's cramp occurred after 12 (range 3–22) years of speed skating. Skater's cramp appeared as task specific; its onset was sudden and correlated to stress and aberrant proprioception. Symptoms presented acutely and consistently during skating, unilaterally in 4 and bilaterally in 1 skater. Visually, skater's cramp was an active, patterned, and person‐specific jerking of a skater's foot, either exo‐ or endorotationally. It presented asymmetrically, repeating persistently as the foot neared the end of the swing phase. The skater's affected leg had a longer swing phase (median, 1.37 [interquartile range {IQR}, 0.35]/1.18 [IQR, 0.24] seconds; P < 0.01), a shorter glide phase (median, 1.09 [IQR, 0.25]/1.26 (IQR, 0.29) seconds; P < 0.01), and higher angular velocity during the jerking motion. Symptoms remained constant irrespective of speed or extra mass around the ankle (P > 0.05). No significant differences between legs were detected in the control group. Conclusions Observed clinical, visual, and kinematic data could be an early and tentative indication of task‐specific dystonia.
Collapse
Affiliation(s)
- Beorn Nijenhuis
- Department of Neurology University Medical Center Groningen, University Groningen Groningen the Netherlands
| | - Aron H P Schalkwijk
- Department of Neurology University Medical Center Groningen, University Groningen Groningen the Netherlands
| | - Sharon Hendriks
- Department of Neurology University Medical Center Groningen, University Groningen Groningen the Netherlands
| | - Rodi Zutt
- Department of Neurology Haga Teaching Hospital the Hague the Netherlands
| | - Egbert Otten
- Department of Movement Sciences University Groningen Groningen Netherlands
| | - Marina A J Tijssen
- Department of Neurology University Medical Center Groningen, University Groningen Groningen the Netherlands
| |
Collapse
|
15
|
Bravi R, Ioannou CI, Minciacchi D, Altenmüller E. Assessment of the effects of Kinesiotaping on musical motor performance in musicians suffering from focal hand dystonia: a pilot study. Clin Rehabil 2019; 33:1636-1648. [PMID: 31159569 DOI: 10.1177/0269215519852408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to explore the immediate and short-term effects of a Correction Kinesiotaping intervention on fine motor control in musicians with focal hand dystonia. DESIGN A single-blinded, single-arm repeated measures, pilot study. SETTING Medical outpatient clinic. SUBJECTS Seven musicians diagnosed with focal hand dystonia. INTERVENTIONS Musicians performed musical exercises under the following conditions: without Kinesiotape (baseline), during a Correction Kinesiotaping intervention and immediately after tape removal (block 1) and during a Sham Kinesiotaping intervention and immediately after tape removal (block 2). Blocks were randomly presented across participants. A tailored Correction Kinesiotaping intervention on affected fingers was provided based on the dystonic pattern that each patient manifested while playing. MAIN MEASURES Motor performance was video-documented and independent experts blindly assessed the general performance and fingers' posture on visual analogue scales. Also, musicians' self-reports of the musical abilities were evaluated. Finally, electromyographic activity and coactivation index of wrist antagonist muscles were analyzed. RESULTS No significant differences in effects between Correction Kinesiotaping and Sham Kinesiotaping were reported by the experts, either for general performance (P > 0.05) or for fingers' posture (P > 0.05); any subtle benefits observed during Correction Kinesiotaping were lost after the tape was removed. Musicians estimated that Correction Kinesiotaping was ineffective in improving their musical abilities. Also, no significant changes with respect to the coactivation index (P > 0.05) were found among the conditions. CONCLUSION Correction Kinesiotaping intervention may not be useful to reduce dystonic patterns, nor to improve playing ability, in musicians with focal hand dystonia.
Collapse
Affiliation(s)
- Riccardo Bravi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Christos I Ioannou
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Diego Minciacchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| |
Collapse
|
16
|
de Lima Xavier L, Simonyan K. The extrinsic risk and its association with neural alterations in spasmodic dysphonia. Parkinsonism Relat Disord 2019; 65:117-123. [PMID: 31153765 DOI: 10.1016/j.parkreldis.2019.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/24/2019] [Accepted: 05/23/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Spasmodic dysphonia (SD) is an isolated focal dystonia characterized by laryngeal spasms during voluntary voice production. Environmental factors have been assumed to play a role in SD pathophysiology; however, the exact extrinsic risk factors and their association with neural alterations remain unknown. METHODS A total of 186 SD patients and 85 healthy controls completed a structured 177-question survey, consisting of questions on general biographical information, medical history, symptomatology of dystonia. Data were imputed in a stepwise regression model to identify extrinsic risk factors for SD. In addition, functional MRI data from a subset of this cohort were analyzed to determine brain activation abnormalities associated with the SD extrinsic risk. RESULTS We found that (1) recurrent upper respiratory infections, gastroesophageal reflux, and neck trauma, all of which influence sensory feedback from the larynx, represent extrinsic risk factors, likely triggering the manifestation of SD symptoms, and (2) neural alterations in the regions necessary for sensorimotor preparation and integration are influenced by an extrinsic risk in susceptible individuals. CONCLUSIONS These findings provide evidence for the extrinsic risk in SD development and demonstrate the link with alterations in the sensorimotor preparatory network that collectively contribute to the multifactorial pathophysiology of SD.
Collapse
Affiliation(s)
- Laura de Lima Xavier
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kristina Simonyan
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
17
|
Brugger F, Peters A, Georgiev D, Kägi G, Balint B, Bhatia KP, Day BL. Sensory trick efficacy in cervical dystonia is linked to processing of neck proprioception. Parkinsonism Relat Disord 2018; 61:50-56. [PMID: 30553617 DOI: 10.1016/j.parkreldis.2018.11.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/02/2018] [Accepted: 11/30/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Muscle vibration activates muscle spindles and when applied over posterior neck muscles during stance modulates global body orientation. This is characterised by a tonic forward sway response that is reportedly diminished or absent in patients with idiopathic cervical dystonia. OBJECTIVE To investigating the impact of the sensory trick on vibration-induced postural responses. METHODS 20 patients with idiopathic cervical dystonia and a sensory trick, 15 patients without a trick, and 16 healthy controls were recruited. Neck muscle vibration was applied bilaterally over the upper trapezius under three different conditions: 1) Quiet standing; 2) standing while performing the trick (or trick-like movement in non-responders); 3) standing while elevating the flexed arm without touching any part of the body. Centre of pressure position and whole-body orientation in the sagittal plane were analysed. RESULTS Patients with a sensory trick responded similarly to healthy controls: neck muscle vibration led to an initial forward sway of the body that slowly increased during the prolonged vibration for all three conditions. This response was mainly mediated by ankle flexion. In patients without a trick, the initial sagittal sway was significantly reduced in all three conditions and the later slow increase was absent. Performance of the trick did not have an effect on any aspect of the response in either cervical dystonia group. CONCLUSIONS The whole-body response to neck vibration in cervical dystonia differs depending on the effectiveness of the sensory trick to alleviate the dystonic neck posture. Variable pathophysiology of proprioceptive processing may be the common factor.
Collapse
Affiliation(s)
- Florian Brugger
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK; Department of Neurology, Kantonsspital, St. Gallen, Switzerland.
| | - Amy Peters
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Dejan Georgiev
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK; Department of Neurology, University Medical Centre Ljubljana, Slovenia
| | - Georg Kägi
- Department of Neurology, Kantonsspital, St. Gallen, Switzerland
| | - Bettina Balint
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Brian L Day
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| |
Collapse
|
18
|
Allgöwer K, Fürholzer W, Hermsdörfer J. Impaired performance of patients with writer's cramp in complex fine motor tasks. Clin Neurophysiol 2018; 129:2392-2402. [PMID: 30278388 DOI: 10.1016/j.clinph.2018.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 08/17/2018] [Accepted: 09/01/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Writer's cramp (WC) is a task-specific focal dystonia. WC is characterized by involuntary contractions of muscles of the hand and arm during handwriting, resulting in impaired writing with exaggerated finger forces. The generalization of symptoms to other fine motor tasks is widely discussed. The aim of the study was to determine affected fine motor aspects with an extensive testing battery. METHODS Twelve people with WC and twelve healthy controls were examined. Performance in the Jebsen-Taylor Hand Function Test, Nine-Hole-Peg Test and 2-point discrimination was evaluated. To analyze object manipulation skills, we examined grip forces, temporal measures and other aspects of force control during (1) lifting actions with variations of weight and surface (2) cyclic movements (3) visuomotor tracking (4) fast force changes and (5) grip strength. In addition, correlation between the dependent variables of the fine motor tasks and the handwriting deficits was assessed. RESULTS WC patients had impaired performance in the visuomotor tracking task (root mean square error (RMSE), p = 0.03 and time lag, p = 0.05) and the fast force changes (frequency, p = 0.01). There were no statistically significant group differences in the other tasks. We found a correlation between the RMSE of the tracking task and the time needed to write the test sentence (r = 0.643, p = 0.01). CONCLUSION WC patients revealed abnormalities in complex fine motor performance in tasks with high demands on coordination and visual components, specifically in tracking and fast force changes. SIGNIFICANCE This suggests a deficit in visuomotor integration, coordination and cognitive aspects related to movement processing particularly with respect to low forces. These insights may prove useful in the development of targeted training approaches.
Collapse
Affiliation(s)
- Kathrin Allgöwer
- Technical University of Munich, Department of Sport and Health Sciences, Chair of Human Movement Science, Munich, Germany.
| | | | - Joachim Hermsdörfer
- Technical University of Munich, Department of Sport and Health Sciences, Chair of Human Movement Science, Munich, Germany
| |
Collapse
|
19
|
A new hypothesis for the pathophysiology of complex regional pain syndrome. Med Hypotheses 2018; 119:41-53. [DOI: 10.1016/j.mehy.2018.07.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/18/2018] [Accepted: 07/27/2018] [Indexed: 12/21/2022]
|
20
|
Avanzino L, Fiorio M, Conte A. Actual and Illusory Perception in Parkinson's Disease and Dystonia: A Narrative Review. Front Neurol 2018; 9:584. [PMID: 30079051 PMCID: PMC6062595 DOI: 10.3389/fneur.2018.00584] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022] Open
Abstract
Sensory information is continuously processed so as to allow behavior to be adjusted according to environmental changes. Before sensory information reaches the cortex, a number of subcortical neural structures select the relevant information to send to be consciously processed. In recent decades, several studies have shown that the pathophysiological mechanisms underlying movement disorders such as Parkinson's disease (PD) and dystonia involve sensory processing abnormalities related to proprioceptive and tactile information. These abnormalities emerge from psychophysical testing, mainly temporal discrimination, as well as from experimental paradigms based on bodily illusions. Although the link between proprioception and movement may be unequivocal, how temporal tactile information abnormalities and bodily illusions relate to motor disturbances in PD and dystonia is still a matter of debate. This review considers the role of altered sensory processing in the pathophysiology of movement disorders, focusing on how sensory alteration patterns differ between PD and dystonia. We also discuss the evidence available and the potential for developing new therapeutic strategies based on the manipulation of multi-sensory information and bodily illusions in patients with these movement disorders.
Collapse
Affiliation(s)
- Laura Avanzino
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| |
Collapse
|
21
|
Sanger TD. Basic and Translational Neuroscience of Childhood-Onset Dystonia: A Control-Theory Perspective. Annu Rev Neurosci 2018; 41:41-59. [PMID: 29490197 DOI: 10.1146/annurev-neuro-080317-061504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dystonia is a collection of symptoms with involuntary muscle activation causing hypertonia, hyperkinetic movements, and overflow. In children, dystonia can have numerous etiologies with varying neuroanatomic distribution. The semiology of dystonia can be explained by gain-of-function failure of a feedback controller that is responsible for stabilizing posture and movement. Because postural control is maintained by a widely distributed network, many different anatomic regions may be responsible for symptoms of dystonia, although all features of dystonia can be explained by uncontrolled activation or hypersensitivity of motor cortical regions that can cause increased reflex gain, inserted postures, or sensitivity to irrelevant sensory variables. Effective treatment of dystonia in children requires an understanding of the relationship between etiology, anatomy, and the specific mechanism of failure of postural stabilization.
Collapse
Affiliation(s)
- Terence D Sanger
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California 90089, USA;
| |
Collapse
|
22
|
Jaynes MJ, Mink JW. Motor sequence awareness is impaired in dystonia despite normal performance. Ann Neurol 2018; 83:52-60. [PMID: 29244239 DOI: 10.1002/ana.25121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 12/10/2017] [Accepted: 12/10/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Dystonia is a movement disorder that has been associated with impaired motor learning and sequence recognition. However, despite evidence that patients with dystonia have a reduced sense of agency, it is unclear whether dystonia is specifically associated with impaired recognition of a movement sequence. We have shown previously that performance consistency in the temporal and kinematic domains predicts awareness of underlying motor patterns in a finger-tapping task. Since movements in dystonia are characterized by high variability, we predicted that subjects with dystonia would have decreased motor sequence awareness. METHODS Subjects with dystonia (n = 20) and healthy control adults (n = 30) performed finger-tapping sequences with a common motor pattern and changing stimulus-to-response mappings. Subjects were said to be "aware" of the motor pattern if they recognized that their fingers moved in the same order during each stimulus-to-response remapping. RESULTS Subjects with dystonia had decreased motor pattern awareness, but those differences were not due to greater performance variability. Subjects with dystonia tapped sequences as series of discrete movements, rather than as a combined series. INTERPRETATION Dystonia is associated with impaired recognition of a repeating movement pattern. This difference may result from a strategy of separating sequential elements and attending to them individually. Ann Neurol 2018;83:52-60.
Collapse
Affiliation(s)
| | - Jonathan W Mink
- Departments of Neurology, Neuroscience, and Pediatrics, University of Rochester, Rochester, NY
| |
Collapse
|
23
|
Avanzino L, Ravaschio A, Lagravinese G, Bonassi G, Abbruzzese G, Pelosin E. Adaptation of feedforward movement control is abnormal in patients with cervical dystonia and tremor. Clin Neurophysiol 2017; 129:319-326. [PMID: 28943258 DOI: 10.1016/j.clinph.2017.08.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/14/2017] [Accepted: 08/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE It is under debate whether the cerebellum plays a role in dystonia pathophysiology and in the expression of clinical phenotypes. We investigated a typical cerebellar function (anticipatory movement control) in patients with cervical dystonia (CD) with and without tremor. METHODS Twenty patients with CD, with and without tremor, and 17 healthy controls were required to catch balls of different load: 15 trials with a light ball, 25 trials with a heavy ball (adaptation) and 15 trials with a light ball (post-adaptation). Arm movements were recorded using a motion capture system. We evaluated: (i) the anticipatory adjustment (just before the impact); (ii) the extent and rate of the adaptation (at the impact) and (iii) the aftereffect in the post-adaptation phase. RESULTS The anticipatory adjustment was reduced during adaptation in CD patients with tremor respect to CD patients without tremor and controls. The extent and rate of adaptation and the aftereffect in the post-adaptation phase were smaller in CD with tremor than in controls and CD without tremor. CONCLUSION Patients with cervical dystonia and tremor display an abnormal predictive movement control. SIGNIFICANCE Our findings point to a possible role of cerebellum in the expression of a clinical phenotype in dystonia.
Collapse
Affiliation(s)
- Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genova, Genova, Italy; Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia.
| | - Andrea Ravaschio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy
| | - Giovanna Lagravinese
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genova, Genova, Italy
| | - Gaia Bonassi
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genova, Genova, Italy
| | - Giovanni Abbruzzese
- Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy
| | - Elisa Pelosin
- Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy
| |
Collapse
|
24
|
Bravi R, Cohen EJ, Martinelli A, Gottard A, Minciacchi D. When Non-Dominant Is Better than Dominant: Kinesiotape Modulates Asymmetries in Timed Performance during a Synchronization-Continuation Task. Front Integr Neurosci 2017; 11:21. [PMID: 28943842 PMCID: PMC5596084 DOI: 10.3389/fnint.2017.00021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/25/2017] [Indexed: 12/25/2022] Open
Abstract
There is a growing consensus regarding the specialization of the non-dominant limb (NDL)/hemisphere system to employ proprioceptive feedback when executing motor actions. In a wide variety of rhythmic tasks the dominant limb (DL) has advantages in speed and timing consistency over the NDL. Recently, we demonstrated that the application of Kinesio® Tex (KT) tape, an elastic therapeutic device used for treating athletic injuries, improves significantly the timing consistency of isochronous wrist’s flexion-extensions (IWFEs) of the DL. We argued that the augmented precision of IWFEs is determined by a more efficient motor control during movements due to the extra-proprioceptive effect provided by KT. In this study, we tested the effect of KT on timing precision of IWFEs performed with the DL and the NDL, and we evaluated the efficacy of KT to counteract possible timing precision difference between limbs. Young healthy subjects performed with and without KT (NKT) a synchronization-continuation task in which they first entrained IWFEs to paced auditory stimuli (synchronization phase), and subsequently continued to produce motor responses with the same temporal interval in the absence of the auditory stimulus (continuation phase). Two inter-onset intervals (IOIs) of 550-ms and 800-ms, one within and the other beyond the boundaries of the spontaneous motor tempo, were tested. Kinematics was recorded and temporal parameters were extracted and analyzed. Our results show that limb advantages in performing proficiently rhythmic movements are not side-locked but depend also on speed of movement. The application of KT significantly reduces the timing variability of IWFEs performed at 550-ms IOI. KT not only cancels the disadvantages of the NDL but also makes it even more precise than the DL without KT. The superior sensitivity of the NDL to use the extra-sensory information provided by KT is attributed to a greater competence of the NDL/hemisphere system to rely on sensory input. The findings in this study add a new piece of information to the context of motor timing literature. The performance asymmetries here demonstrated as preferred temporal environments could reflect limb differences in the choice of sensorimotor control strategies for the production of human movement.
Collapse
Affiliation(s)
- Riccardo Bravi
- Department of Experimental and Clinical Medicine, University of FlorenceFlorence, Italy
| | - Erez J Cohen
- Department of Experimental and Clinical Medicine, University of FlorenceFlorence, Italy
| | - Alessio Martinelli
- Department of Information Engineering, University of FlorenceFlorence, Italy
| | - Anna Gottard
- Department of Statistics, Informatics, Applications, University of FlorenceFlorence, Italy
| | - Diego Minciacchi
- Department of Experimental and Clinical Medicine, University of FlorenceFlorence, Italy
| |
Collapse
|
25
|
Sedov A, Popov V, Shabalov V, Raeva S, Jinnah HA, Shaikh AG. Physiology of midbrain head movement neurons in cervical dystonia. Mov Disord 2017; 32:904-912. [PMID: 28218416 DOI: 10.1002/mds.26948] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Early theories for cervical dystonia, as promoted by Hassler, emphasized the role of the midbrain interstitial nucleus of Cajal. Focus then shifted to the basal ganglia, and it was further supported with the success of deep brain stimulation. Contemporary theories suggested the role of the cerebellum, but even more recent hypotheses renewed interest in the midbrain. Although the pretectum was visited on several occasions, we still do not know about the physiology of midbrain neurons in cervical dystonia. METHODS We analyzed the unique database of pretectal neurons collected in the 1970s and 1980s during historic stereotactic surgeries aimed to treat cervical dystonia. This database is valuable because such recordings could otherwise never be obtained from humans. RESULTS We found the following 3 types of eye or neck movement sensitivity: eye-only neurons responded to pure vertical eye movements, neck-only neurons were sensitive to pure neck movements, and the combined eye-neck neurons responded to eye and neck movements. There were the 2 neuronal subtypes: burst-tonic and tonic. The eye-neck or eye-only neurons sustained their activity during eccentric gaze holding. In contrast, the response of neck-only and eye-neck neurons exponentially decayed during neck movements. CONCLUSIONS Modern quantitative analysis of a historic database of midbrain single units from patients with cervical dystonia might support novel hypotheses for normal and abnormal head movements. This data, collected almost 4 decades ago, must be carefully viewed, especially because it was acquired using a less sophisticated technology available at that time and the aim was not to address specific hypothesis, but to make an accurate lesion providing optimal relief from dystonia. © 2017 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Alexey Sedov
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russia.,Moscow Institute of Physics and Technology, Moscow, Russia
| | - Valentin Popov
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russia.,Burdenko Scientific Research Neurosurgery Institute, Moscow, Russia
| | | | - Svetlana Raeva
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - H A Jinnah
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Aasef G Shaikh
- Department of Neurology, Emory University, Atlanta, Georgia, USA.,Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA.,Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Neurology Service and Daroff-Dell'Osso Ocular Motility Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
| |
Collapse
|
26
|
Carment L, Maier MA, Sangla S, Guiraud V, Mesure S, Vidailhet M, Lindberg PG, Bleton JP. Does dystonic muscle activity affect sense of effort in cervical dystonia? PLoS One 2017; 12:e0172019. [PMID: 28192488 PMCID: PMC5305099 DOI: 10.1371/journal.pone.0172019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 01/30/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Focal dystonia has been associated with deficient processing of sense of effort cues. However, corresponding studies are lacking in cervical dystonia (CD). We hypothesized that dystonic muscle activity would perturb neck force control based on sense of effort cues. METHODS Neck extension force control was investigated in 18 CD patients with different clinical features (7 with and 11 without retrocollis) and in 19 control subjects. Subjects performed force-matching and force-maintaining tasks at 5% and 20% of maximum voluntary contraction (MVC). Three task conditions were tested: i) with visual force feedback, ii) without visual feedback (requiring use of sense of effort), iii) without visual feedback, but with neck extensor muscle vibration (modifying muscle afferent cues). Trapezius muscle activity was recorded using electromyography (EMG). RESULTS CD patients did not differ in task performance from healthy subjects when using visual feedback (ANOVA, p>0.7). In contrast, when relying on sense of effort cues (without visual feedback, 5% MVC), force control was impaired in patients without retrocollis (p = 0.006), but not in patients with retrocollis (p>0.2). Compared to controls, muscle vibration without visual feedback significantly affected performance in patients with retrocollis (p<0.001), but not in patients without retrocollis. Extensor EMG during rest, included as covariate in ANOVA, explained these group differences. CONCLUSION This study shows that muscle afferent feedback biases sense of effort cues when controlling neck forces in patients with CD. The bias acts on peripheral or central sense of effort cues depending on whether the task involves dystonic muscles. This may explain why patients with retrocollis more accurately matched isometric neck extension forces. This highlights the need to consider clinical features (pattern of dystonic muscles) when evaluating sensorimotor integration in CD.
Collapse
Affiliation(s)
- Loïc Carment
- FR3636, CNRS / Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marc A Maier
- FR3636, CNRS / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Sophie Sangla
- Service de Neurologie, Fondation OPH de Rothschild, Paris, France
| | - Vincent Guiraud
- Université Paris Descartes, Sorbonne Paris Cité, INSERM U894, Paris, France.,Service de Neurologie et Unité Neurovasculaire, Hôpital Sainte-Anne, Paris, France
| | - Serge Mesure
- UMR 7287, CNRS Aix Marseille Université, Institut des Sciences du Mouvement, Marseille, France
| | - Marie Vidailhet
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Paris, France.,AP-HP, Hôpital de la Pitié Salpêtrière, Département de Neurologie, Paris, France
| | - Påvel G Lindberg
- FR3636, CNRS / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Centre de Psychiatrie et Neurosciences, Inserm U894, Paris, France
| | | |
Collapse
|
27
|
Liyanagamage SA, Bertucco M, Bhanpuri NH, Sanger TD. Scaled Vibratory Feedback Can Bias Muscle Use in Children With Dystonia During a Redundant, 1-Dimensional Myocontrol Task. J Child Neurol 2017; 32:161-169. [PMID: 27798370 PMCID: PMC5258677 DOI: 10.1177/0883073816671830] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vibratory feedback can be a useful tool for rehabilitation. We examined its use in children with dystonia to understand how it affects muscle activity in a population that does not respond well to standard rehabilitation. We predicted scaled vibration (ie, vibration that was directly or inversely proportional to muscle activity) would increase use of the vibrated muscle because of task-relevant sensory information, whereas nonscaled vibration would not change muscle use. The study was conducted on 11 subjects with dystonia and 14 controls. Each subject underwent 4 different types of vibration on the more dystonic biceps muscle (or nondominant arm in controls) in a 1-dimensional, bimanual myocontrol task. Our results showed that only scaled vibratory feedback could bias muscle use without changing overall performance in children with dystonia. We believe there may be a role in rehabilitation for scaled vibratory feedback to retrain abnormal muscle patterns.
Collapse
Affiliation(s)
- Shanie A Liyanagamage
- 1 Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| | - Matteo Bertucco
- 1 Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| | - Nasir H Bhanpuri
- 1 Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| | - Terence D Sanger
- 1 Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.,2 Department of Neurology, University of Southern California, Los Angeles, CA, USA.,3 Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, CA, USA.,4 Children's Hospital of Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
28
|
Perozzo P, Salatino A, Cerrato P, Ricci R. Sexual Well-Being in Patients with Blepharospasm, Spasmodic Torticollis, and Hemifacial Spasm: A Pilot Study. Front Psychol 2016; 7:1492. [PMID: 27761118 PMCID: PMC5050215 DOI: 10.3389/fpsyg.2016.01492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/16/2016] [Indexed: 11/23/2022] Open
Abstract
Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson's disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available.
Collapse
Affiliation(s)
| | - Adriana Salatino
- SAMBA (SpAtial, Motor & Bodily Awareness) Research Group, Psychology Department, University of Turin, TurinItaly
| | - Paolo Cerrato
- Stroke Unit, Department of Neuroscience, University of Turin, TurinItaly
| | - Raffaella Ricci
- SAMBA (SpAtial, Motor & Bodily Awareness) Research Group, Psychology Department, University of Turin, TurinItaly
- Neuroscience Institute of Turin, University of Turin, TurinItaly
| |
Collapse
|
29
|
Furuya S, Tominaga K, Miyazaki F, Altenmüller E. Losing dexterity: patterns of impaired coordination of finger movements in musician's dystonia. Sci Rep 2015; 5:13360. [PMID: 26289433 PMCID: PMC4542337 DOI: 10.1038/srep13360] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/24/2015] [Indexed: 11/23/2022] Open
Abstract
Extensive training can bring about highly-skilled action, but may also impair motor dexterity by producing involuntary movements and muscular cramping, as seen in focal dystonia (FD) and tremor. To elucidate the underlying neuroplastic mechanisms of FD, the present study addressed the organization of finger movements during piano performance in pianists suffering from the condition. Principal component (PC) analysis identified three patterns of fundamental joint coordination constituting finger movements in both patients and controls. The first two coordination patterns described less individuated movements between the “dystonic” finger and key-striking fingers for patients compared to controls. The third coordination pattern, representing the individuation of movements between the middle and ring fingers, was evident during a sequence of strikes with these fingers in controls, which was absent in the patients. Consequently, rhythmic variability of keystrokes was more pronounced during this sequence of strikes for the patients. A stepwise multiple-regression analysis further identified greater variability of keystrokes for individuals displaying less individuated movements between the affected and striking fingers. The findings suggest that FD alters dexterous joint coordination so as to lower independent control of finger movements, and thereby degrades fine motor control.
Collapse
Affiliation(s)
- Shinichi Furuya
- Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Emmichplatz 1, Hanover, Germany 30175.,Department of Information and Communication Sciences, Sophia University, Tokyo, Japan, 1020081
| | - Kenta Tominaga
- Department of Engineering Science, Osaka University, Osaka, Japan, 5608531
| | - Fumio Miyazaki
- Department of Engineering Science, Osaka University, Osaka, Japan, 5608531
| | - Eckart Altenmüller
- Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Emmichplatz 1, Hanover, Germany 30175
| |
Collapse
|
30
|
Avanzino L, Tinazzi M, Ionta S, Fiorio M. Sensory-motor integration in focal dystonia. Neuropsychologia 2015; 79:288-300. [PMID: 26164472 DOI: 10.1016/j.neuropsychologia.2015.07.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/04/2015] [Accepted: 07/07/2015] [Indexed: 01/24/2023]
Abstract
Traditional definitions of focal dystonia point to its motor component, mainly affecting planning and execution of voluntary movements. However, focal dystonia is tightly linked also to sensory dysfunction. Accurate motor control requires an optimal processing of afferent inputs from different sensory systems, in particular visual and somatosensory (e.g., touch and proprioception). Several experimental studies indicate that sensory-motor integration - the process through which sensory information is used to plan, execute, and monitor movements - is impaired in focal dystonia. The neural degenerations associated with these alterations affect not only the basal ganglia-thalamic-frontal cortex loop, but also the parietal cortex and cerebellum. The present review outlines the experimental studies describing impaired sensory-motor integration in focal dystonia, establishes their relationship with changes in specific neural mechanisms, and provides new insight towards the implementation of novel intervention protocols. Based on the reviewed state-of-the-art evidence, the theoretical framework summarized in the present article will not only result in a better understanding of the pathophysiology of dystonia, but it will also lead to the development of new rehabilitation strategies.
Collapse
Affiliation(s)
- Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, 16132 genoa, Italy
| | - Michele Tinazzi
- Department of Neurological and Movement Sciences, University of Verona, 37131 Verona, Italy
| | - Silvio Ionta
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Mirta Fiorio
- Department of Neurological and Movement Sciences, University of Verona, 37131 Verona, Italy.
| |
Collapse
|