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Sensory disinhibition on passive movement in cervical dystonia
Author(s) -
Obermann Mark,
Vollrath Clemens,
de Greiff Armin,
Gizewski Elke R.,
Diener HansChristoph,
Hallett Mark,
Maschke Matthias
Publication year - 2010
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.23321
Subject(s) - cervical dystonia , disinhibition , somatosensory system , sensory system , neuroscience , psychology , dystonia , supplementary motor area , functional magnetic resonance imaging , focal dystonia , physical medicine and rehabilitation , movement disorders , spasmodic torticollis , neurological disorder , medicine , central nervous system disease , disease
The relevance of the sensory system in the pathophysiology of cervical dystonia (CD) has been discussed since the description of sensory tricks associated with this disorder. Our objective was to locate changes in somatosensory processing of patients with CD responding in a passive sensory task of body regions that are not affected by dystonic symptoms. We used functional magnetic resonance imaging (fMRI) in 17 patients with CD and 17 healthy controls performing a strictly passive 30‐degree forearm movement task with the left arm. TSUI and TWSTRS rating scales were used for clinical assessment. All patients were treated with botulinum neurotoxin type A (BoNT‐A; Dysport®). Patients with CD showed BOLD‐signal increase in the contralateral primary and secondary sensory cortex, the cingulate cortex and cerebellum bilaterally compared to healthy controls. We found a strong positive correlation of this activation with BoNT‐A dosage in the supplementary motor area (SMA) and a negative correlation with the TWSTRS in that same region. The observed sensory overactivation suggests a general disinhibition of the somatosensory system in CD as it was not limited to the motor‐system or the direct neuronal representation of the affected dystonic musculature alone. © 2010 Movement Disorder Society