Cortical Plasticity and Its Implications for Focal Hand Dystonia

Opavský, Robert; Hluštı́k, Petr; Kaňovský, Petr

doi:10.5507/bp.2006.031

Cited by 6 publications

(3 citation statements)

References 36 publications

(36 reference statements)

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“…Both scales seemed to measure the benefit of DBS for dystonia effectively. Another interesting finding was that in some cases patients improved significantly more between the 6-and 12-month timepoints than between baseline and 6 months, supporting the notion of a delayed benefit in DBS for dystonia [6,9,12,51,55] and suggesting the possibility of a neuroplastic effect [39,42]. The blinded assessments from our study were lower in magnitude than the majority of those seen in previously published studies (see Tables 9, 10).…”

Section: Discussionsupporting

confidence: 44%

An evaluation of rating scales utilized for deep brain stimulation for dystonia

et al. 2009

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The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. These 75 examination videos were retrospectively evaluated, independently and in random order, by two movement disorder neurologists who were blinded to the treatment status. Both neurologists scored each videotaped evaluation using the Burke-Fahn-Marsden Dystonia Rating Scale-motor part (BFMDRS-M) and the Unified Dystonia Rating Scale (UDRS). A final score for each video was assigned by averaging the raters' scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters' results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary dystonia.

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Section: Discussionsupporting

confidence: 44%

An evaluation of rating scales utilized for deep brain stimulation for dystonia

et al. 2009

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“…Task-specific focal hand dystonia (tspFHD) is an uncommon disorder of movement (Opavsky 2006) characterized by involuntary end range twisting postures of the fingers, wrist and forearm when performing a specific task. While the etiology of focal hand dystonia is considered idiopathic, most researchers and clinicians agree it is a multifactorial disorder which results from an interaction of intrinsic and extrinsic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Amplitude and timing of somatosensory cortex activity in task-specific focal hand dystonia

Dolberg

Hinkley

Honma

et al. 2011

Clinical Neurophysiology

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Objective Task-specific focal hand dystonia (tspFHD) is a movement disorder diagnosed in individuals performing repetitive hand behaviors. The extent to which processing anomalies in primary sensory cortex extend to other regions or across the two hemispheres is presently unclear. Methods In response to low/high rate and novel tactile stimuli on the affected and unaffected hands, magnetoencephalography (MEG) was used to elaborate activity timing and amplitude in the primary somatosensory (S1) and secondary somatosensory/parietal ventral (S2/PV) cortices. MEG and clinical performance measures were collected from thirteen patients and matched controls. Results Compared to controls, subjects with tspFHD had increased response amplitude in S2/PV bilaterally in response to high rate and novel stimuli. Subjects with tspFHD also showed increased response latency (low rate, novel) of the affected digits in contralateral S1. For high rate, subjects with tspFHD showed increased response latency in ipsilateral S1 and S2/PV bilaterally. Activation differences correlated with functional sensory deficits (predicting a latency shift in S1), motor speed and muscle strength. Conclusions There are objective differences in the amplitude and timing of activity for both hands across contralateral and ipsilateral somatosensory cortex in patients with tspFHD. Significance Knowledge of cortical processing abnormalities across S1 and S2/PV in dystonia should be applied towards the development of learning based sensorimotor interventions.

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“…However, another study has shown that abnormal gray matter density in patients with BSP was related to the course of disease ( Suzuki et al, 2011 ). The conflicting results may be due to abnormal sensory motor plasticity ( Abbruzzese and Berardelli, 2011 ) and neuronal remodeling uncertainty ( Opavsky et al, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

Voxel-Mirrored Homotopic Connectivity of Resting-State Functional Magnetic Resonance Imaging in Blepharospasm

Wei

Yang

et al. 2018

Front. Psychol.

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Objective: Several networks in human brain are involved in the development of blepharospasm. However, the underlying mechanisms for this disease are poorly understood. A voxel-mirrored homotopic connectivity (VMHC) method was used to quantify the changes in functional connectivity between two hemispheres of the brain in patients with blepharospasm.Methods: Twenty-four patients with blepharospasm and 24 healthy controls matched by age, sex, and education were recruited. The VMHC method was employed to analyze the fMRI data. The support vector machine (SVM) method was utilized to examine whether these abnormalities could be applied to distinguish the patients from the controls.Results: Compared with healthy controls, patients with blepharospasm showed significantly high VMHC in the inferior temporal gyrus, interior frontal gyrus, posterior cingulate cortex, and postcentral gyrus. No significant correlation was found between abnormal VMHC values and clinical variables. SVM analysis showed a combination of increased VMHC values in two brain areas with high sensitivities and specificities (83.33 and 91.67% in the combined inferior frontal gyrus and posterior cingulate cortex; and 83.33 and 87.50% in the combined inferior temporal gyrus and postcentral gyrus).Conclusion: Enhanced homotopic coordination in the brain regions associated with sensory integration networks and default-mode network may be underlying the pathophysiology of blepharospasm. This phenomenon may serve as potential image markers to distinguish patients with blepharospasm from healthy controls.

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Cortical Plasticity and Its Implications for Focal Hand Dystonia

Cited by 6 publications

References 36 publications

An evaluation of rating scales utilized for deep brain stimulation for dystonia

An evaluation of rating scales utilized for deep brain stimulation for dystonia

Amplitude and timing of somatosensory cortex activity in task-specific focal hand dystonia

Voxel-Mirrored Homotopic Connectivity of Resting-State Functional Magnetic Resonance Imaging in Blepharospasm

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