Chen R, Hallett M
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1428, USA.
Clin Orthop Relat Res. 1998 Jun(351):102-6.
It commonly is observed that focal hand dystonias, such as writer's cramp or musician's cramp, are associated with repetitive movements, although definitive proof of a causal relationship is lacking. These focal dystonias are often task specific, with involuntary muscle contractions occurring only when patients perform specific acts such as writing or playing a musical instrument. Physiologic studies show deficiencies in spinal reciprocal inhibition and abnormalities of central sensory processing and motor output that may be related to reduced cortical inhibition. Recent studies in primates support the notion that repetitive motions can induce plasticity changes in the sensory cortex leading to degradation of topographic representations of the hand, and raise the possibility that sensory training may be beneficial. Current treatment options for focal dystonia include botulinum toxin injections, anticholinergics, baclofen, benzodiazepines, and occupational therapy.
人们通常观察到，局部性手部肌张力障碍，如书写痉挛或音乐家痉挛，与重复性动作有关，尽管缺乏因果关系的确切证据。这些局部性肌张力障碍通常是特定任务性的，只有当患者进行特定行为，如书写或演奏乐器时，才会出现非自愿性肌肉收缩。生理学研究表明，脊髓交互抑制存在缺陷，中枢感觉处理和运动输出异常，这可能与皮质抑制降低有关。最近对灵长类动物的研究支持了这样一种观点，即重复性动作可诱导感觉皮层发生可塑性变化，导致手部地形图表征退化，并增加了感觉训练可能有益的可能性。目前针对局部性肌张力障碍的治疗选择包括肉毒杆菌毒素注射、抗胆碱能药物、巴氯芬、苯二氮䓬类药物和职业治疗。
