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不同类型局灶性肌张力障碍患者的异常感觉门控。

Abnormal sensory gating in patients with different types of focal dystonias.

机构信息

Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.

IRCCS NEUROMED, Pozzilli, IS, Italy.

出版信息

Mov Disord. 2018 Dec;33(12):1910-1917. doi: 10.1002/mds.27530. Epub 2018 Nov 7.

Abstract

BACKGROUND

Movement execution in healthy individuals increases the somatosensory temporal discrimination threshold. These changes are a result of mechanisms of sensory gating at the subcortical level. Although the somatosensory temporal discrimination threshold is abnormally increased in patients with focal dystonias, the effect of movement execution on somatosensory temporal discrimination in dystonic patients is unknown.

OBJECTIVES

The objective of this study was to determine whether somatosensory temporal discrimination threshold modulation induced by voluntary movement is normal in different forms of focal dystonia.

METHODS

We enrolled 71 dystonic patients (24 with blepharospasm, 31 with cervical dystonia, and 16 with focal hand dystonia) and 39 age-matched healthy participants. Paired stimuli for the somatosensory temporal discrimination threshold were triggered by movement execution at movement onset and at various time intervals thereafter. We analyzed the kinematic features of the motor task to ascertain whether tactile input induces changes in movement parameters.

RESULTS

Movement execution led to greater and longer lasting increases in somatosensory temporal discrimination threshold values, both upon movement onset and at various time intervals thereafter, in patients with cervical dystonia and focal hand dystonia than in those with blepharospasm or the healthy participants. Somatosensory temporal discrimination testing did not induce any changes in the mean velocity of index finger movements in either patients or healthy participants.

CONCLUSIONS

Somatosensory temporal discrimination threshold changes induced by movement execution are abnormal in focal dystonias. This abnormality is related to the type of dystonia. Abnormal gating of sensory information is likely involved in movement-induced triggering or worsening of different forms focal dystonia. © 2018 International Parkinson and Movement Disorder Society.

摘要

背景

健康个体的运动执行会增加体感时间辨别阈值。这些变化是皮质下水平感觉门控机制的结果。虽然局灶性肌张力障碍患者的体感时间辨别阈值异常增加,但运动执行对肌张力障碍患者体感时间辨别阈值的影响尚不清楚。

目的

本研究旨在确定不同形式的局灶性肌张力障碍患者的体感时间辨别阈值调制是否受自愿运动的影响。

方法

我们招募了 71 名肌张力障碍患者(24 名眼睑痉挛,31 名颈部肌张力障碍,16 名局灶性手部肌张力障碍)和 39 名年龄匹配的健康参与者。体感时间辨别阈值的配对刺激是在运动开始时和此后的不同时间间隔由运动执行触发的。我们分析了运动任务的运动学特征,以确定触觉输入是否会引起运动参数的变化。

结果

与眼睑痉挛或健康参与者相比,颈部肌张力障碍和局灶性手部肌张力障碍患者的运动执行在运动开始时以及此后的不同时间间隔内,体感时间辨别阈值的增加更大且持续时间更长。体感时间辨别测试在患者或健康参与者中均未引起食指运动平均速度的任何变化。

结论

运动执行引起的体感时间辨别阈值变化在局灶性肌张力障碍中是异常的。这种异常与肌张力障碍的类型有关。感觉信息的异常门控可能涉及不同形式的局灶性肌张力障碍的运动触发或恶化。© 2018 国际帕金森病和运动障碍学会。

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