Bologna Matteo, Berardelli Alfredo
Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy.
Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy.
Handb Clin Neurol. 2018;155:259-272. doi: 10.1016/B978-0-444-64189-2.00017-2.
Dystonia is a heterogeneous disorder characterized by involuntary muscle contractions, twisting movements, and abnormal postures in various body regions. It is widely accepted that the basal ganglia are involved in the pathogenesis of dystonia. A growing body of evidence, however, is challenging the traditional view and suggest that the cerebellum may also play a role in dystonia. Studies on animals indicate that experimental manipulations of the cerebellum lead to dystonic-like movements. Several clinical observations, including those from secondary dystonia cases as well as neurophysiologic and neuroimaging studies in human patients, provide further evidence in humans of a possible relationship between cerebellar abnormalities and dystonia. Claryfing the role of the cerebellum in dystonia is an important step towards providing alternative treatments based on noninvasive brain stimulation techniques.
肌张力障碍是一种异质性疾病,其特征为身体各部位出现不自主肌肉收缩、扭转运动和异常姿势。基底神经节参与肌张力障碍的发病机制这一观点已被广泛接受。然而,越来越多的证据正在挑战传统观点,并表明小脑可能也在肌张力障碍中发挥作用。对动物的研究表明,对小脑进行实验性操作会导致类似肌张力障碍的运动。一些临床观察结果,包括来自继发性肌张力障碍病例的观察结果以及对人类患者的神经生理学和神经影像学研究,为人类小脑异常与肌张力障碍之间可能存在的关系提供了进一步证据。明确小脑在肌张力障碍中的作用是朝着基于非侵入性脑刺激技术提供替代治疗迈出的重要一步。