Department of Neurology and Clinical Neurophysiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands.
BioMechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands.
Toxins (Basel). 2017 Aug 23;9(9):256. doi: 10.3390/toxins9090256.
Botulinum toxin (BoNT) injections in the dystonic muscles is the preferred treatment for Cervical Dystonia (CD), but the proper identification of the dystonic muscles remains a challenge. Previous studies showed decreased 8-14 Hz autospectral power in the electromyography (EMG) of splenius muscles in CD patients. Cumulative distribution functions (CDF's) of dystonic muscles showed increased CDF values, representing increased autospectral powers between 3 and 10 Hz, relative to power between 3 and 32 Hz. In this study, we evaluated both methods and investigated the effects of botulinum toxin. Intramuscular EMG recordings were obtained from the splenius, semispinalis, and sternocleidomastoid muscles during standardized isometric tasks in 4 BoNT-naïve CD patients, 12 BoNT-treated patients, and 8 healthy controls. BoNT-treated patients were measured 4-7 weeks after their last BoNT injections and again after 11-15 weeks. We found significantly decreased 8-14 Hz autospectral power in splenius muscles, but not in the semispinalis and sternocleidomastoid muscles of CD patients when compared to healthy controls. CDF analysis was superior in demonstrating subtle autospectral changes, and showed increased CDF values in all studied muscles of CD patients. These results did not change significantly after BoNT injections. Further studies are needed to investigate the origin of these autospectral changes in dystonia patients, and to assess their potential in muscle selection for BoNT treatment.
肉毒毒素（BoNT）注射到痉挛肌中是治疗颈肌张力障碍（CD）的首选方法，但正确识别痉挛肌仍然是一个挑战。先前的研究表明，CD 患者的斜方肌肌电图（EMG）中 8-14 Hz 自谱功率降低。痉挛肌的累积分布函数（CDF）显示，相对于 3-32 Hz 之间的功率，3-10 Hz 之间的自谱功率的 CDF 值增加，代表增加。在这项研究中，我们评估了这两种方法，并研究了肉毒毒素的作用。在 4 名未经 BoNT 治疗的 CD 患者、12 名接受 BoNT 治疗的患者和 8 名健康对照者进行标准化等长任务期间，从斜方肌、半棘肌和胸锁乳突肌中获得了肌内 EMG 记录。BoNT 治疗的患者在最后一次 BoNT 注射后 4-7 周和 11-15 周后再次测量。与健康对照组相比，我们发现 CD 患者的斜方肌中 8-14 Hz 自谱功率明显降低，但半棘肌和胸锁乳突肌中没有。CDF 分析在显示细微的自谱变化方面更具优势，并且在 CD 患者的所有研究肌肉中均显示 CDF 值增加。BoNT 注射后这些变化没有显著变化。需要进一步研究以探讨这些在肌张力障碍患者中出现的自谱变化的起源，并评估其在 BoNT 治疗中肌肉选择中的潜在作用。
