Hsu Prisca, Jobst Cecilia, Isabella Silvia L, Domi Trish, Westmacott Robyn, Dlamini Nomazulu, Cheyne Douglas
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Hum Brain Mapp. 2025 Apr 1;46(5):e70204. doi: 10.1002/hbm.70204.
Dystonia is a movement disorder characterized by repetitive muscle contractions, twisting movements, and abnormal posture, affecting 20% of pediatric arterial ischemic stroke (AIS) survivors. Recent studies have reported that children with dystonia are at higher risk of cognitive deficits. The connection between impaired motor outcomes and cognitive impairment in dystonia is not fully understood; dystonia might affect motor control alone, or it could also contribute to cognitive impairment through disruptions in higher-order motor processes. To assess the functional correlates underlying motor control in children with dystonia, we used magnetoencephalography (MEG) to measure frontal theta (4-8 Hz), motor beta (15-30 Hz), and sensorimotor gamma (60-90 Hz) activity during a "go"/"no-go" task. Beamformer-based source analysis was carried out on 19 post-stroke patients: nine with dystonia (mean age = 13.78, SD = 2.82, 8 females), 10 without dystonia (mean age = 12.90, SD = 3.54, 4 females), and 17 healthy controls (mean age = 12.82, SD = 2.72, 8 females). To evaluate inhibitory control, frontal theta activity was analyzed during correct "no-go" (successful withhold) trials. To assess motor execution and sensorimotor integration, movement time-locked beta and sensorimotor gamma activity were analyzed during correct "go" trials. Additionally, the Delis-Kaplan Executive Function System (DKEFS) color-word interference task was used as a non-motor, inhibitory control task to evaluate general cognitive inhibition abilities. During affected hand use, dystonia patients had higher "no-go" error rates (failed withhold) compared to all other groups. Dystonia patients also exhibited higher frontal theta power during correct withhold responses for both affected and unaffected hands compared to healthy controls. Furthermore, dystonia patients exhibited decreased movement-evoked gamma power and gamma peak frequency compared to non-dystonia patients and healthy controls. Movement-related beta desynchronization (ERD) activity was increased in non-dystonia patients for both hands compared to healthy participants. These results confirm that post-stroke dystonia is associated with impaired frontally mediated inhibitory control, as reflected by increased frontal theta power. Post-stroke dystonia patients also exhibited reduced motor gamma activity during movement, reflecting altered sensorimotor integration. The increased beta ERD activity in non-dystonia patients may suggest compensatory sensorimotor plasticity not observed in dystonia patients. These findings suggest that differences in motor outcomes in childhood stroke result from a combination of cognitive and motor deficits.
肌张力障碍是一种运动障碍,其特征为重复性肌肉收缩、扭转运动和异常姿势,影响20%的小儿动脉缺血性卒中(AIS)幸存者。最近的研究报告称,患有肌张力障碍的儿童出现认知缺陷的风险更高。肌张力障碍中运动结果受损与认知障碍之间的联系尚未完全明确;肌张力障碍可能仅影响运动控制,也可能通过高阶运动过程的中断导致认知障碍。为了评估肌张力障碍患儿运动控制的功能相关性,我们使用脑磁图(MEG)在“执行”/“不执行”任务期间测量额叶θ波(4 - 8赫兹)、运动β波(15 - 30赫兹)和感觉运动γ波(60 - 90赫兹)活动。对19名卒中后患者进行了基于波束形成器的源分析:9名患有肌张力障碍(平均年龄 = 13.78,标准差 = 2.82,8名女性),10名没有肌张力障碍(平均年龄 = 12.90,标准差 = 3.54,4名女性),以及17名健康对照者(平均年龄 = 12.82,标准差 = 2.72,8名女性)。为了评估抑制控制,在正确的“不执行”(成功抑制)试验期间分析额叶θ波活动。为了评估运动执行和感觉运动整合,在正确的“执行”试验期间分析运动时间锁定的β波和感觉运动γ波活动。此外,使用Delis - Kaplan执行功能系统(DKEFS)颜色 - 词干扰任务作为非运动性抑制控制任务来评估一般认知抑制能力。在使用患侧手时,与所有其他组相比,肌张力障碍患者的“不执行”错误率(抑制失败)更高。与健康对照者相比,肌张力障碍患者在患侧手和非患侧手正确抑制反应期间的额叶θ波功率也更高。此外,与非肌张力障碍患者和健康对照者相比,肌张力障碍患者的运动诱发γ波功率和γ波峰值频率降低。与健康参与者相比,非肌张力障碍患者双手的运动相关β波去同步化(ERD)活动增加。这些结果证实,卒中后肌张力障碍与额叶介导的抑制控制受损有关,表现为额叶θ波功率增加。卒中后肌张力障碍患者在运动期间的感觉运动γ波活动也减少,反映出感觉运动整合改变。非肌张力障碍患者β波ERD活动增加可能表明存在肌张力障碍患者未观察到的代偿性感觉运动可塑性。这些发现表明,儿童卒中运动结果的差异是由认知和运动缺陷共同导致的。