Motor overflow and mirror dystonia

Sitburana, Oraporn; Wu, Lung‐Sheng; Sheffield, James K.; Davidson, Anthony; Jankovic, Joseph

doi:10.1016/j.parkreldis.2009.05.003

Cited by 50 publications

(39 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, dystonia that emerges during the first year of life has a very high probability of being due to an Motor overflow commonly found in dystonia is unintentional muscle contraction which accompanies, but is anatomically distinct from the primary dystonic movement. 46,47 It commonly occurs at the peak of dystonic movements.…”

Section: Age At Onsetmentioning

confidence: 99%

Phenomenology and classification of dystonia: A consensus update

et al. 2013

Self Cite

View full text Add to dashboard Cite

This report describes the consensus outcome of an international panel consisting of investigators with years of experience in this field that reviewed the definition and classification of dystonia. Agreement was obtained based on a consensus development methodology during three in-person meetings and manuscript review by mail. Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned and twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. Dystonia is classified along two axes: clinical characteristics, including age at onset, body distribution, temporal pattern and associated features (additional movement disorders or neurological features), and etiology, which includes nervous system pathology and inheritance. The clinical characteristics fall into several specific dystonia syndromes that help to guide diagnosis and treatment. We provide here a new general definition of dystonia and propose a new classification. We encourage clinicians and researchers to use these innovative definition and classification and test them in the clinical setting on a variety of patients with dystonia.

show abstract

Section: Age At Onsetmentioning

confidence: 99%

Phenomenology and classification of dystonia: A consensus update

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this regard, voluntary movement of the contralateral (unaffected) hand may elicit the primary dystonic posture in the affected hand. This is “mirror dystonia,” which refers to a phenomenon in which voluntary movements contralateral to the affected limb provoke dystonic movements on the affected side (10, 11). For instance, in writer’s cramp when writing with the unaffected non-dominant hand, the normal voluntary movement can provoke or cause recapitulation of the dystonic movements in the affected hand, even though it is not engaged in the writing task.…”

Section: Clinical Featuresmentioning

confidence: 99%

Research Priorities in Limb and Task-Specific Dystonias

et al. 2017

Self Cite

View full text Add to dashboard Cite

Dystonia, which causes intermittent or sustained abnormal postures and movements, can present in a focal or a generalized manner. In the limbs, focal dystonia can occur in either the upper or lower limbs and may be task-specific causing abnormal motor performance for only a specific task, such as in writer’s cramp, runner’s dystonia, or musician’s dystonia. Focal limb dystonia can be non-task-specific and may, in some circumstances, be associated with parkinsonian disorders. The true prevalence of focal limb dystonia is not known and is likely currently underestimated, leaving a knowledge gap and an opportunity for future research. The pathophysiology of focal limb dystonia shares some commonalities with other dystonias with a loss of inhibition in the central nervous system and a loss of the normal regulation of plasticity, called homeostatic plasticity. Functional imaging studies revealed abnormalities in several anatomical networks that involve the cortex, basal ganglia, and cerebellum. Further studies should focus on distinguishing cause from effect in both physiology and imaging studies to permit focus on most relevant biological correlates of dystonia. There is no specific therapy for the treatment of limb dystonia given the variability in presentation, but off-label botulinum toxin therapy is often applied to focal limb and task-specific dystonia. Various rehabilitation techniques have been applied and rehabilitation interventions may improve outcomes, but small sample size and lack of direct comparisons between methods to evaluate comparative efficacy limit conclusions. Finally, non-invasive and invasive therapeutic modalities have been explored in small studies with design limitations that do not yet clearly provide direction for larger clinical trials that could support new clinical therapies. Given these gaps in our clinical, pathophysiologic, and therapeutic knowledge, we have identified priorities for future research including: the development of diagnostic criteria for limb dystonia, more precise phenotypic characterization and innovative clinical trial design that considers clinical heterogeneity, and limited available number of participants.

show abstract

“…A voluntary compensatory posturing may not easily be distinguishable from overflow 7,8,10,11,12 . Usually, voluntary movements are slower and more variable.…”

Section: Overflowmentioning

confidence: 99%

“…It could be considered as a subset of motor overflow. The existence of simultaneous activation of the cortical spinal pathway, mediated by the impaired inhibition of transcallosal commissure, has been hypothesized 7,8,10,11,12,13 .…”

Section: Mirroringmentioning

confidence: 99%

Understanding dystonia: diagnostic issues and how to overcome them

Camargos

Cardoso

2016

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

The diagnosis and treatment of dystonia are challenging. This is likely due to gaps in the complete understanding of its pathophysiology, lack of animal models for translational studies, absence of a consistent pathological substrate and highly variable phenotypes and genotypes. The aim of this review article is to provide an overview of the clinical, neurophysiological and genetic features of dystonia that can help in the identification of this movement disorder, as well as in the differential diagnosis of the main forms of genetic dystonia. The variation of penetrance, age of onset, and topographic distribution of the disease in carriers of the same genetic mutation indicates that other factors -either genetic or environmental -might be involved in the development of symptoms. The growing knowledge of cell dysfunction in mutants may give insights into more effective therapeutic targets.Keywords: dystonia; apoptosis. RESUMOO diagnóstico e o tratamento da distonia podem ser desafiadores. Isso se dá provavelmente a pouca compreensão da fisiopatologia, a falta de modelos animais para estudos translacionais, ausência de um substrato patológico consistente e genótipo e fenótipo altamente variáveis. O objetivo deste artigo de revisão é fornecer uma visão geral dos aspectos clínicos, neurofisiológicos e genéticos de distonia que podem ajudar na identificação deste distúrbio do movimento, bem como no diagnóstico diferencial das principais formas de distonia hereditária. Há uma ênfase particular na nova definição e classificação da Internacional das Distonias, bem como as recentes descobertas dos mecanismos moleculares subjacentes em algumas formas de distonia primária. A variação de penetrância, idade de início, e distribuição topográfica da doença em portadores da mesma mutação genética indica que outros fatores -genéticos ou ambientais podem estar envolvidos no desenvolvimento dos sintomas. O conhecimento crescente sobre a disfunção celular em mutantes pode gerar insights sobre alvos terapêuticos mais eficazes.Palavras-chave: distonia; apoptose

show abstract

Motor overflow and mirror dystonia

Cited by 50 publications

References 30 publications

Phenomenology and classification of dystonia: A consensus update

Phenomenology and classification of dystonia: A consensus update

Research Priorities in Limb and Task-Specific Dystonias

Understanding dystonia: diagnostic issues and how to overcome them

Contact Info

Product

Resources

About