Section of Human Physiology, Department of Experimental Medicine, Centro Polifunzionale di Scienze Motorie, University of Genoa , Genoa , Italy.
Department of Neurological and Movement Sciences, University of Verona , Verona , Italy.
Front Hum Neurosci. 2014 Dec 9;8:1000. doi: 10.3389/fnhum.2014.01000. eCollection 2014.
Dystonia has historically been considered a disorder of the basal ganglia, mainly affecting planning and execution of voluntary movements. This notion comes from the observation that most lesions responsible for secondary dystonia involve the basal ganglia. However, what emerges from recent research is that dystonia is linked to the dysfunction of a complex neural network that comprises basal ganglia-thalamic-frontal cortex, but also the inferior parietal cortex and the cerebellum. While dystonia is clearly a motor problem, it turned out that sensory aspects are also fundamental, especially those related to proprioception. We outline experimental evidence for proprioceptive dysfunction in focal dystonia from intrinsic sensory abnormalities to impaired sensorimotor integration, which is the process by which sensory information is used to plan and execute volitional movements. Particularly, we will focus on proprioceptive aspects of dystonia, including: (i) processing of vibratory input, (ii) temporal discrimination of two passive movements, (iii) multimodal integration of visual-tactile and proprioceptive inputs, and (iv) motor control in the absence of visual feedback. We suggest that these investigations contribute not only to a better understanding of dystonia pathophysiology, but also to develop rehabilitation strategies aimed at facilitating the processing of proprioceptive input.
特发性肌张力障碍历来被认为是基底节的一种疾病，主要影响随意运动的规划和执行。这种观点来自于这样一个观察结果，即大多数导致继发性肌张力障碍的病变都涉及基底节。然而，最近的研究表明，肌张力障碍与包括基底节-丘脑-皮质、顶叶下皮质和小脑在内的复杂神经网络的功能障碍有关。虽然肌张力障碍显然是一种运动问题，但事实证明，感觉方面也很重要，特别是与本体感觉有关的方面。我们从内在感觉异常到感觉运动整合受损概述了局灶性肌张力障碍的本体感觉功能障碍的实验证据，感觉运动整合是指利用感觉信息来规划和执行随意运动的过程。特别是，我们将重点介绍肌张力障碍的本体感觉方面，包括：（i）振动输入的处理，（ii）两个被动运动的时间辨别，（iii）视觉-触觉和本体感觉输入的多模态整合，以及（iv）在没有视觉反馈的情况下的运动控制。我们认为，这些研究不仅有助于更好地理解肌张力障碍的病理生理学，还有助于制定旨在促进本体感觉输入处理的康复策略。
