Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom.
Mov Disord. 2013 Nov;28(13):1874-7. doi: 10.1002/mds.25581. Epub 2013 Jul 12.
We investigated whether clinical improvement observed after deep brain stimulation (DBS) of the globus pallidus internus (GPi) in cervical dystonia (CD) is paralleled by the normalisation of temporal discrimination thresholds (TDTs), a marker of abnormal sensory processing in CD.
TDT was tested in 11 patients with CD after they received DBS and was compared with TDT scores from 24 patients with CD and a group of 61 controls.
A clear clinical response to GPi-DBS was demonstrated (total Toronto Western Spasmodic Torticollis Rating Scale scores fell from 50 to 18; P < 0.001). In contrast, TDT remained abnormal in the CD-DBS group (P < 0.001) and was not significantly different from the abnormal TDT range observed in CD.
Underlying sensory abnormalities in temporal discrimination observed in dystonia do not seem to be corrected by successful GPi-DBS. This adds further data to the ongoing debate regarding which pathophysiological abnormalities observed in dystonia are likely to be causal in the genesis of the disease rather than epiphenomena observed secondary to abnormal motor activity.
我们研究了深部脑刺激（DBS）治疗颈肌张力障碍（CD）患者的苍白球 internus（GPi）后观察到的临床改善是否与正常的时间辨别阈值（TDT）相平行，TDT 是 CD 中异常感觉处理的标志。
在接受 DBS 治疗后，我们对 11 例 CD 患者进行了 TDT 测试，并与 24 例 CD 患者和 61 例对照组的 TDT 评分进行了比较。
明确证明了 GPi-DBS 的明显临床反应（多伦多西部痉挛性斜颈总评分从 50 降至 18；P<0.001）。相比之下，CD-DBS 组的 TDT 仍然异常（P<0.001），与 CD 中观察到的异常 TDT 范围没有显著差异。
在 DBS 治疗后，在时间辨别中观察到的感觉异常似乎并未得到纠正。这为关于在 DBS 中观察到的哪些生理异常可能是疾病发生的因果关系，而不是继发于异常运动活动的继发现象的持续争论提供了更多的数据。
