Braun Christoph, Schweizer Renate, Heinz Udo, Wiech Katja, Birbaumer Niels, Topka Helge
Institute of Medical Psychology und Behavioral Neurobiology, University of Tübingen, Germany.
Neuroimage. 2003 Oct;20(2):1329-38. doi: 10.1016/S1053-8119(03)00375-6.
Focal dystonias such as writer's cramp are characterized by muscular cramps that accompany the execution of specific motor tasks. Until now, the pathophysiology of focal dystonia remains incompletely understood. Recent studies suggest that the development of writer's cramp is related to abnormal organization of primary somatosensory cortex (SI), which in turn leads to impaired motor function. To explore contributions of SI on mechanisms of task specificity in focal dystonia, we investigated dynamic alterations in the functional organization of SI as well as sensory-motor gating for rest, left- and right-handed writing and brushing in writer's cramp patients and healthy controls. The functional organization of somatosensory cortex was assessed by neuromagnetic source imaging (151 channel whole-head MEG). In accordance with previous reports, distances between cortical representations of thumb and little finger of the affected hand were smaller in patients compared to healthy subjects. However, similar to healthy controls, patients showed normal modulation of the functional organization of SI as induced by the execution of different motor tasks. Both in the control subjects and patients, cortical distances between representations of thumb and little finger increased when writing and brushing compared to the resting condition. Although, cramps only occured during writing, no differences in the organization of SI were seen among motor tasks. Our data suggest that despite alterations in the organization of primary somatosensory cortex in writer's cramp, the capability of SI to adapt dynamically to different tasks is not impaired.
诸如书写痉挛等局灶性肌张力障碍的特征是在执行特定运动任务时伴有肌肉痉挛。到目前为止,局灶性肌张力障碍的病理生理学仍未完全了解。最近的研究表明,书写痉挛的发展与初级体感皮层(SI)的异常组织有关,这反过来又导致运动功能受损。为了探究SI对局灶性肌张力障碍任务特异性机制的作用,我们研究了书写痉挛患者和健康对照者在休息、左手和右手书写及刷牙时SI功能组织的动态变化以及感觉运动门控。体感皮层的功能组织通过神经磁源成像(151通道全头MEG)进行评估。与先前的报告一致,与健康受试者相比,患者患侧手拇指和小指的皮层表征之间的距离更小。然而,与健康对照者相似,患者在执行不同运动任务时,SI功能组织的调节正常。在对照受试者和患者中,与休息状态相比,书写和刷牙时拇指和小指表征之间的皮层距离均增加。尽管痉挛仅在书写时出现,但在不同运动任务之间,SI的组织未见差异。我们的数据表明,尽管书写痉挛患者的初级体感皮层组织存在改变,但SI动态适应不同任务的能力并未受损。