Anastasopoulos Dimitri, Maurer Christoph, Mergner Thomas
Neurologische Klinik, Neurozentrum, Universität Freiburg, Breisacherstraße 64, 79106 Freiburg, Germany; Department of Physiology and Clinical Neurophysiology, School of Health Sciences, University of Athens, Tetrapoleos 8, 11527 Goudi, Athens, Greece.
Neurologische Klinik, Neurozentrum, Universität Freiburg, Breisacherstraße 64, 79106 Freiburg, Germany.
Parkinsonism Relat Disord. 2014 Nov;20(11):1165-70. doi: 10.1016/j.parkreldis.2014.08.008. Epub 2014 Aug 20.
To investigate deficiencies in mechanisms of sensorimotor processing and reflexive-voluntary interactions leading to the impaired head position control in primary cervical dystonia.
Thirteen patients and 23 healthy controls were subjected to transient, low amplitude, low velocity head-on-trunk, trunk-under-head and whole-body rotations in the horizontal plane. With the instruction not to resist the imposed displacements, resistance to horizontal neck deflections was evaluated.
Patients exhibited a torque offset (bias) in the direction of torticollis before stimulus application. While controls reduced and occasionally eliminated completely the initial resistance to head-to-trunk rotations, torque in patients increased throughout displacements. Change of resistance relative to baseline in patients was, however, symmetrical, i.e. independent of torticollis direction. Spontaneous torque fluctuations were significantly larger in patients. Strong correlations existed among these abnormal findings.
Patients' ability to manipulate normal postural reactions to head-trunk rotations is impaired. The deficit is bilateral and correlates with the degree of abnormal posture. The present study extends previous work on reflexive-voluntary interactions and provides evidence that malfunctioning proprioceptive feedback may contribute to the pathophysiology of cervical dystonia.
研究感觉运动处理机制和反射性 - 自主性相互作用的缺陷，这些缺陷导致原发性颈部肌张力障碍患者头部位置控制受损。
对13例患者和23名健康对照者进行水平面上短暂、低幅度、低速度的头部相对于躯干、躯干支撑头部及全身旋转。在不抵抗施加位移的指令下，评估对水平颈部偏斜的阻力。
患者在刺激施加前就表现出向斜颈方向的扭矩偏移（偏差）。对照组在头部相对于躯干旋转时，会降低并偶尔完全消除初始阻力，而患者的扭矩在整个位移过程中增加。然而，患者相对于基线的阻力变化是对称的，即与斜颈方向无关。患者的自发扭矩波动明显更大。这些异常发现之间存在强相关性。
患者操纵头部 - 躯干旋转正常姿势反应的能力受损。这种缺陷是双侧的，且与异常姿势的程度相关。本研究扩展了先前关于反射性 - 自主性相互作用的工作，并提供证据表明本体感觉反馈功能失调可能导致颈部肌张力障碍的病理生理学。
