Leis A A, Dimitrijevic M R, Delapasse J S, Sharkey P C
Baylor College of Medicine, Division of Restorative Neurology and Human Neurobiology, Houston, TX 77030.
J Neurol Sci. 1992 Jul;110(1-2):79-89. doi: 10.1016/0022-510x(92)90013-b.
Cervical dystonia is often refractory to all forms of therapy. Many patients, however, are able to transiently abolish their spasms following a specific gesture that presumably enhances sensory input. Such observations prompted us to develop a protocol to determine if various forms of sensory stimulation could modify the motor control patterns in cervical dystonia. Surface EMG recordings of multiple neck and trunk muscles were obtained in 11 consecutive cervical dystonia patients. Baseline patterns of voluntary and involuntary muscle activation were established during a series of motor and non-motor tasks. The tasks were repeated during the application of vibratory or electrical stimulation to select muscle groups or to cutaneous and mixed nerves. Analysis of the results was made on the basis of paper and computer recordings of the data. Sensory stimulation decreased involuntary muscle activity and reduced spasms in 5 subjects. However, objective or subjective improvement usually occurred only after specific stimuli were applied to specific anatomical sites. In these cases, the protocol identified the site at which a specific sensory stimulus could be applied to control the dystonia. We conclude that selective sensory stimulation can beneficially modify cervical dystonia in some patients. Such findings warrant further investigation of the use of sensory stimulation for control of cervical dystonia.
颈部肌张力障碍通常对所有形式的治疗都具有难治性。然而，许多患者在做出特定姿势后能够短暂消除痉挛，据推测该姿势可增强感觉输入。这些观察结果促使我们制定了一项方案，以确定各种形式的感觉刺激是否能改变颈部肌张力障碍的运动控制模式。我们对11例连续的颈部肌张力障碍患者进行了多块颈部和躯干肌肉的表面肌电图记录。在一系列运动和非运动任务中建立了自愿性和非自愿性肌肉激活的基线模式。在对选定的肌肉群或皮肤及混合神经施加振动或电刺激期间重复这些任务。基于纸质和计算机数据记录对结果进行分析。感觉刺激使5名受试者的非自愿性肌肉活动减少，痉挛减轻。然而，客观或主观改善通常仅在对特定解剖部位施加特定刺激后才会出现。在这些情况下，该方案确定了可应用特定感觉刺激来控制肌张力障碍的部位。我们得出结论，选择性感觉刺激可使部分患者的颈部肌张力障碍得到有益改善。这些发现值得进一步研究将感觉刺激用于控制颈部肌张力障碍。
