Di Biasio Francesca, Marchese Roberta, Abbruzzese Giovanni, Baldi Ottavia, Esposito Marcello, Silvestre Francesco, Tescione Girolamo, Berardelli Alfredo, Fabbrini Giovanni, Ferrazzano Gina, Pellicciari Roberta, Eleopra Roberto, Devigili Grazia, Bono Francesco, Santangelo Domenico, Bertolasi Laura, Altavista Maria Concetta, Moschella Vincenzo, Barone Paolo, Erro Roberto, Albanese Alberto, Scaglione Cesa, Liguori Rocco, Cotelli Maria Sofia, Cossu Giovanni, Ceravolo Roberto, Coletti Moja Mario, Zibetti Maurizio, Pisani Antonio, Petracca Martina, Tinazzi Michele, Maderna Luca, Girlanda Paolo, Magistrelli Luca, Misceo Salvatore, Romano Marcello, Minafra Brigida, Modugno Nicola, Aguggia Marco, Cassano Daniela, Defazio Giovanni, Avanzino Laura
IRCCS Policlinico San Martino, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy.
Front Neurol. 2020 Aug 26;11:906. doi: 10.3389/fneur.2020.00906. eCollection 2020.
Cervical dystonia (CD) is one of the most common forms of adult-onset isolated dystonia. Recently, CD has been classified according to the site of onset and spread, in different clinical subgroups, that may represent different clinical entities or pathophysiologic subtypes. In order to support this hypothesis, in this study we have evaluated whether different subgroups of CD, that clinically differ for site of onset and spread, also imply different sensorimotor features. Clinical and demographic data from 842 patients with CD from the Italian Dystonia Registry were examined. Motor features (head tremor and tremor elsewhere) and sensory features (sensory trick and neck pain) were investigated. We analyzed possible associations between motor and sensory features in CD subgroups [focal neck onset, no spread (FNO-NS); focal neck onset, segmental spread (FNO-SS); focal onset elsewhere with segmental spread to neck (FOE-SS); segmental neck involvement without spread (SNI)]. In FNO-NS, FOE-SS, and SNI subgroups, head tremor was associated with the presence of tremor elsewhere. Sensory trick was associated with pain in patients with FNO-NS and with head tremor in patients with FNO-SS. The frequent association between head tremor and tremor elsewhere may suggest a common pathophysiological mechanism. Two mechanisms may be hypothesized for sensory trick: a gating mechanism attempting to reduce pain and a sensorimotor mechanism attempting to control tremor.
颈部肌张力障碍（CD）是成人起病的孤立性肌张力障碍最常见的形式之一。最近，根据起病部位和扩散情况，CD被分为不同的临床亚组，这些亚组可能代表不同的临床实体或病理生理亚型。为了支持这一假设，在本研究中，我们评估了临床上在起病部位和扩散情况方面存在差异的不同CD亚组是否也意味着不同的感觉运动特征。我们检查了来自意大利肌张力障碍登记处的842例CD患者的临床和人口统计学数据。研究了运动特征（头部震颤和其他部位震颤）和感觉特征（感觉技巧和颈部疼痛）。我们分析了CD亚组[局灶性颈部起病，无扩散（FNO-NS）；局灶性颈部起病，节段性扩散（FNO-SS）；其他部位局灶性起病并节段性扩散至颈部（FOE-SS）；节段性颈部受累但无扩散（SNI）]中运动和感觉特征之间可能的关联。在FNO-NS、FOE-SS和SNI亚组中，头部震颤与其他部位震颤的存在相关。感觉技巧在FNO-NS亚组患者中与疼痛相关，在FNO-SS亚组患者中与头部震颤相关。头部震颤与其他部位震颤之间的频繁关联可能提示一种共同的病理生理机制。对于感觉技巧，可以假设两种机制：一种是试图减轻疼痛的门控机制，另一种是试图控制震颤的感觉运动机制。
