Cerebellar Modulation of Sensorimotor Associative Plasticity Is Impaired in Cervical Dystonia

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2023-08-28 DOI:10.1002/mds.29586

Kai Grimm MD, Lisa Prilop MD, Gerhard Schön MSc, Mathias Gelderblom MD, Jonas Misselhorn PhD, Christian Gerloff MD, Simone Zittel MD

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Abstract

Background

In recent years, cervical dystonia (CD) has been recognized as a network disorder that involves not only the basal ganglia but other brain regions, such as the primary motor and somatosensory cortex, brainstem, and cerebellum. So far, the role of the cerebellum in the pathophysiology of dystonia is only poorly understood.

Objective

The objective of this study was to investigate the role of the cerebellum on sensorimotor associative plasticity in patients with CD.

Methods

Sixteen patients with CD and 13 healthy subjects received cerebellar transcranial direct current stimulation (ctDCS) followed by a paired associative stimulation (PAS) protocol based on transcranial magnetic stimulation that induces sensorimotor associative plasticity. Across three sessions the participants received excitatory anodal, inhibitory cathodal, and sham ctDCS in a double-blind crossover design. Before and after the intervention, motor cortical excitability and motor symptom severity were assessed.

Results

PAS induced an increase in motor cortical excitability in both healthy control subjects and patients with CD. In healthy subjects this effect was attenuated by both anodal and cathodal ctDCS with a stronger effect of cathodal stimulation. In patients with CD, anodal stimulation suppressed the PAS effect, whereas cathodal stimulation had no influence on PAS. Motor symptom severity was unchanged after the intervention.

Conclusions

Cerebellar modulation with cathodal ctDCS had no effect on sensorimotor associative plasticity in patients with CD, in contrast with the net inhibitory effect in healthy subjects. This is further evidence that the cerebello-thalamo-cortical network plays a role in the pathophysiology of dystonia. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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查看原文本刊更多论文

颈肌张力障碍患者小脑感觉运动联想可塑性调节受损。

背景:近年来，颈肌张力障碍(CD)被认为是一种网络障碍，不仅涉及基底节区，还涉及其他脑区，如初级运动和体感皮层、脑干和小脑。到目前为止，小脑在肌张力障碍病理生理中的作用还知之甚少。目的:探讨CD患者小脑在感觉运动联想可塑性中的作用。方法:16例CD患者和13名健康对照者分别接受经颅直流电刺激(ctDCS)和基于经颅磁刺激的配对联想刺激(PAS)方案，诱导感觉运动联想可塑性。在双盲交叉设计中，参与者接受兴奋性阳极、抑制性阴极和假性ctDCS治疗。干预前后分别评估运动皮质兴奋性和运动症状严重程度。结果:PAS诱导健康对照者和CD患者的运动皮质兴奋性增加。在健康受试者中，正极和阴极ctDCS均能减弱这一作用，其中阴极刺激的作用更强。在CD患者中，阳极刺激抑制PAS效应，而阴极刺激对PAS无影响。干预后运动症状严重程度无变化。结论:与健康受试者的净抑制作用相反，用阴极ctDCS调节小脑对CD患者的感觉运动联想可塑性没有影响。这进一步证明小脑-丘脑-皮质网络在肌张力障碍的病理生理中起作用。©2023作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.