Laura Avanzino1, Amel Cherif2, Oscar Crisafulli2, Federico Carbone2, Jacopo Zenzeri2, Pietro Morasso2, Giovanni Abbruzzese2, Elisa Pelosin2, Jürgen Konczak2. 1. From the Department of Experimental Medicine (L.A.), Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, Department of Informatics, Bioengineering, Robotics and System Engineering (A.C.), and Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (O.C., F.C., G.A., E.P.), University of Genova; Ospedale Policlinico San Martino (L.A., E.P.), IRCCS; Robotics, Brain and Cognitive Sciences Department (A.C., J.Z., P.M.), Istituto Italiano di Tecnologia, Genoa, Italy; and Human Sensorimotor Control Laboratory (J.K.), Center for Clinical Movement Science and School of Kinesiology, University of Minnesota, Minneapolis. lavanzino76@gmail.com. 2. From the Department of Experimental Medicine (L.A.), Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, Department of Informatics, Bioengineering, Robotics and System Engineering (A.C.), and Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (O.C., F.C., G.A., E.P.), University of Genova; Ospedale Policlinico San Martino (L.A., E.P.), IRCCS; Robotics, Brain and Cognitive Sciences Department (A.C., J.Z., P.M.), Istituto Italiano di Tecnologia, Genoa, Italy; and Human Sensorimotor Control Laboratory (J.K.), Center for Clinical Movement Science and School of Kinesiology, University of Minnesota, Minneapolis.
Abstract
OBJECTIVE: To determine whether different phenotypes of cervical dystonia (CD) express different types and levels of somatosensory impairment. METHODS: We assessed somatosensory function in patients with CD with and without tremor (n = 12 each) and in healthy age-matched controls (n = 22) by measuring tactile temporal discrimination thresholds of the nondystonic forearm and proprioceptive acuity in both the dystonic (head/neck) and nondystonic body segments (forearm/hand) using a joint position-matching task. The head or the wrist was passively displaced along different axes to distinct joint positions by the experimenter or through a robotic exoskeleton. Participants actively reproduced the experienced joint position, and the absolute joint position-matching error between the target and the reproduced positions served as a marker of proprioceptive acuity. RESULTS: Tactile temporal discrimination thresholds were significantly elevated in both CD subgroups compared to controls. Proprioceptive acuity of both the dystonic and nondystonic body segments was elevated in patients with CD and tremor with respect to both healthy controls and patients with CD without tremor. That is, tactile abnormalities were a shared dysfunction of both CD phenotypes, while proprioceptive dysfunction was observed in patients with CD with tremor. CONCLUSIONS: Our findings suggest that the pathophysiology in CD can be characterized by 2 abnormal neural processes: a dysfunctional somatosensory gating mechanism involving the basal ganglia that triggers involuntary muscle spasms and abnormal processing of proprioceptive information within a defective corticocerebellar loop, likely affecting the feedback and feedforward control of head positioning. This dysfunction is expressed mainly in CD with tremor.
OBJECTIVE: To determine whether different phenotypes of cervical dystonia (CD) express different types and levels of somatosensory impairment. METHODS: We assessed somatosensory function in patients with CD with and without tremor (n = 12 each) and in healthy age-matched controls (n = 22) by measuring tactile temporal discrimination thresholds of the nondystonic forearm and proprioceptive acuity in both the dystonic (head/neck) and nondystonic body segments (forearm/hand) using a joint position-matching task. The head or the wrist was passively displaced along different axes to distinct joint positions by the experimenter or through a robotic exoskeleton. Participants actively reproduced the experienced joint position, and the absolute joint position-matching error between the target and the reproduced positions served as a marker of proprioceptive acuity. RESULTS: Tactile temporal discrimination thresholds were significantly elevated in both CD subgroups compared to controls. Proprioceptive acuity of both the dystonic and nondystonic body segments was elevated in patients with CD and tremor with respect to both healthy controls and patients with CD without tremor. That is, tactile abnormalities were a shared dysfunction of both CD phenotypes, while proprioceptive dysfunction was observed in patients with CD with tremor. CONCLUSIONS: Our findings suggest that the pathophysiology in CD can be characterized by 2 abnormal neural processes: a dysfunctional somatosensory gating mechanism involving the basal ganglia that triggers involuntary muscle spasms and abnormal processing of proprioceptive information within a defective corticocerebellar loop, likely affecting the feedback and feedforward control of head positioning. This dysfunction is expressed mainly in CD with tremor.
Authors: Elizabeth Cisneros; Glenn T Stebbins; Qiyu Chen; Jeanne P Vu; Casey N Benadof; Zheng Zhang; Richard L Barbano; Susan H Fox; Christopher G Goetz; Joseph Jankovic; Hyder A Jinnah; Joel S Perlmutter; Charles H Adler; Stewart A Factor; Stephen G Reich; Ramon Rodriguez; Lawrence L Severt; Natividad P Stover; Brian D Berman; Cynthia L Comella; David A Peterson Journal: J Neurol Sci Date: 2020-11-01 Impact factor: 3.181
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Authors: Meng Wang; Tolulope Sajobi; Francesca Morgante; Charles Adler; Pinky Agarwal; Tobias Bäumer; Alfredo Berardelli; Brian D Berman; Joel Blumin; Max Borsche; Allison Brashear; Andres Deik; Kevin Duque; Alberto J Espay; Gina Ferrazzano; Jeanne Feuerstein; Susan Fox; Samuel Frank; Mark Hallett; Joseph Jankovic; Mark S LeDoux; Julie Leegwater-Kim; Abhimanyu Mahajan; Irene A Malaty; William Ondo; Alexander Pantelyat; Sarah Pirio-Richardson; Emmanuel Roze; Rachel Saunders-Pullman; Oksana Suchowersky; Daniel Truong; Marie Vidailhet; Aparna Wagle Shukla; Joel S Perlmutter; Hyder A Jinnah; Davide Martino Journal: Eur J Neurol Date: 2021-08-04 Impact factor: 6.288
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