任务特异性肌张力障碍的诊断性神经生理学生物标志物
Diagnostic Neurophysiologic Biomarkers for Task-Specific Dystonia.
作者信息
Merchant Shabbir Hussain I, Wu Tianxia, Hallett Mark
机构信息
Department of Neurology, Division of Movement Disorders, Harvard Medical School Beth Israel Deaconess Medical Center Boston Massachusetts USA.
National Institute of Neurological Disorders and Stroke National Institute of Health Bethesda Maryland USA.
出版信息
Mov Disord Clin Pract. 2022 Apr 14;9(4):468-472. doi: 10.1002/mdc3.13448. eCollection 2022 May.
BACKGROUND
Task-specific dystonia (TSD) is a challenging clinical diagnosis with no objective diagnostic biomarkers.
OBJECTIVE
The objective of this study was to test 2 neurophysiologic variables using transcranial magnetic stimulation as potential diagnostic biomarkers for TSD.
METHODS
We tested (1) cortical silent period (CSP) and (2) dorsal inferior parietal lobule-motor cortex (dIPL-M1) physiologic connectivity in 9 patients with the writer's cramp form of TSD and 12 healthy volunteers on 2 separate sessions.
RESULTS
CSP was significantly prolonged ( < 0.0001) in TSD and could classify TSD with high sensitivity and specificity with areas under the receiver operating characteristic curve (AUCs) = 0.94 and 0.90, respectively, for 2 separate sessions with an intraclass correlation = 0.79. dIPL-M1 interaction was notable for significant motor cortical inhibition in TSD compared with facilitation in healthy subjects ( < 0.0001) and could classify TSD with high sensitivity and specificity with AUCs = 0.96 and 0.86, respectively.
CONCLUSION
CSP and dIPL-M1 physiologic connectivity can classify TSD with high sensitivity, specificity, reproducibility, and reliability.
背景
任务特异性肌张力障碍（TSD）是一种具有挑战性的临床诊断，没有客观的诊断生物标志物。
目的
本研究的目的是使用经颅磁刺激测试2种神经生理学变量作为TSD的潜在诊断生物标志物。
方法
我们在2个不同的时间段对9例书写痉挛型TSD患者和12名健康志愿者测试了（1）皮质静息期（CSP）和（2）顶下小叶背侧-运动皮质（dIPL-M1）的生理连接性。
结果
TSD患者的CSP显著延长（<0.0001），并且可以以高敏感性和特异性对TSD进行分类，在2个不同时间段的受试者操作特征曲线（AUC）下面积分别为0.94和0.90，组内相关系数为0.79。与健康受试者的促进作用相比，TSD患者的dIPL-M1相互作用表现为显著的运动皮质抑制（<0.0001），并且可以以高敏感性和特异性对TSD进行分类，AUC分别为0.96和0.86。
结论
CSP和dIPL-M1生理连接性可以以高敏感性、特异性、可重复性和可靠性对TSD进行分类。
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