Alteration of digital representations in somatosensory cortex in focal hand dystonia

Elbert, Thomas; Candia, Victor; Altenmüller, Eckart; Rau, Harald; Sterr, Annette; Rockstroh, Brigitte; Pantev, Christo; Taub, Edward

doi:10.1097/00001756-199811160-00006

Cited by 397 publications

(257 citation statements)

References 19 publications

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“…These findings are consistent with those from earliier work from our lab (Byl et al, 1996;Byl et al, 1997), and are consistent with human imaging results (Bara-Jimenez et al, 1998;Byl et al, 2000;Elbert et al, 1998). Abnormal combinations of receptive fields and large sectors of the somatosensory thalamus with continuous representations were also found in human general dystonia patients (Lenz and Byl, 1999).…”

Section: Discussion Evaluation Of Hypothesis On Physiology Of the Causupporting

confidence: 90%

Sensory representation abnormalities that parallel focal hand dystonia in a primate model

Blake

Byl

Cheung

et al. 2002

Somatosensory & Motor Research

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In our hypothesis of focal dystonia, attended repetitive behaviors generate aberrant sensory representations. Those aberrant representations interfere with motor control. Abnormal motor control strengthens sensory abnormalities. The positive feedback loop reinforces the dystonic condition. Previous studies of primates with focal hand dystonia have demonstrated multi-digit or hairyglabrous responses at single sites in area 3b, receptive fields that average ten times larger than normal, and high receptive field overlap as a function of horizontal distance. In this study, we strengthen and elaborate these findings. One animal was implanted with an array of micro-electrodes that spanned the border between the face and digits. After the animal developed hand dystonia, responses in the initial hand representation increasingly responded to low threshold stimulation of the face in a columnar substitution. The hand-face border that is normally sharp became patchy and smeared over one millimeter of cortex within six weeks. Two more trained animals developed a focal hand dystonia variable in severity across the hand. Receptive field size, presence of multi-digit or hairy-glabrous receptive fields, and columnar overlap covaried with the animal's ability to use specific digits. A fourth animal performed the same behaviors without developing dystonia. Many of its physiological measures were similar to the dystonic animals, but receptive field overlap functions were minimally abnormal, and no sites shared response properties that are normally segregated such as hairy-glabrous combined fields, or multi-digit fields. Thalamic mapping demonstrated proportionate levels of abnormality in thalamic representations as was found in cortical representations.

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Section: Discussion Evaluation Of Hypothesis On Physiology Of the Causupporting

confidence: 90%

Sensory representation abnormalities that parallel focal hand dystonia in a primate model

Blake

Byl

Cheung

et al. 2002

Somatosensory & Motor Research

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“…We extend this work to musicians with focal hand dystonia and are able to report evidence for usedependent CNS plasticity. Previously, using neuromagnetic source imaging, we reported a smearing of the homuncular organization of the representation of the digits in primary somatosensory cortex with this population (2). Although this observation does not require causal primacy of the central mechanism, we assumed that behaviorally manipulated usedependent plasticity could potentially be of value in changing both cortical organization and the involuntary discoordination of finger movements.…”

mentioning

confidence: 68%

“…This disorder has been recently confirmed by using functional MRI to compare the brain dynamics of the sensory cortex in response to single vs. combined tactile stimulation of the index and middle fingers (6). The present study was designed to investigate whether SMR treatment would also induce observable alterations in the organization of the somatosensory cortex previously shown to be deviant in musicians with focal hand dystonia (2).…”

mentioning

confidence: 89%

“…Focal hand dystonia is a motor disorder involving abnormal hand and finger positions, cramps, and noncoordinated movements of the hand and fingers (1)(2)(3)(4)(5)(6)(7)(8). It can be so disabling that patients have to limit or give up their occupation.…”

mentioning

confidence: 99%

“…In addition, it has been suggested that the modification can contribute to the development of focal hand dystonia. This view suggests that synchronous activation of several digits by vigorous and frequent musical practice leads to a disordered and smeared representation of the fingers in somatosensory and probably also in motor cortex, with the inability to move the most affected fingers separately (2,18). Also, sufficient evidence now exists to demonstrate a corresponding defective perception and abnormal sensory processing in focal hand dystonia (5,(19)(20)(21)(22).…”

mentioning

confidence: 99%

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Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

Candia

Wienbruch

Elbert

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

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158

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New perspectives in neurorehabilitation suggest that behavioral treatments of movement disorders may modify the functional organization of central somatosensory neural networks. On the basis of the assumption that use-dependent reorganization in these networks contributes to the fundamental abnormalities seen in focal dystonia, we treated 10 affected musicians and measured the concomitant somatosensory changes by using whole-head magnetoencephalography. We found that effective treatment, using the method of sensory motor retuning, leads to alterations in the functional organization of the somatosensory cortex. Specifically, before treatment, somatosensory relationships of the individual fingers differ between the affected and unaffected hands, whereas after treatment, finger representations contralateral to the dystonic side become more similar to the less-affected side. Further, somatosensory finger representations are ordered more according to homuncular principles after treatment. In addition, the observed physiologic changes correlated with behavioral data. These results confirm that plastic changes in parallel with emergent neurological dysfunction may be reversed by contextspecific, intensive training-based remediation.

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Sensory discrimination capabilities in patients with focal hand dystonia

et al. 2000

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To explore the concept that dystonia may result from dysfunction of the sensory system, 14 patients with focal hand dystonia were tested during two somatosensory discrimination tasks. Compared with controls, patients had a higher threshold in a task involving discrimination of two electric stimuli closely related temporally, an abnormality that correlated with the degree of severity of dystonia. There was no significant difference in a single‐touch, gross localization task. The possible relevance of these findings to the pathogenesis of dystonia is discussed. Ann Neurol 2000;47:377–380

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Alteration of digital representations in somatosensory cortex in focal hand dystonia

Cited by 397 publications

References 19 publications

Sensory representation abnormalities that parallel focal hand dystonia in a primate model

Sensory representation abnormalities that parallel focal hand dystonia in a primate model

Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

Sensory discrimination capabilities in patients with focal hand dystonia

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