Sensory tricks initiating before skin contact: New observations in drug-induced tardive dystonia

Miwa Hagita , Masaya Kubota
{"title":"Sensory tricks initiating before skin contact: New observations in drug-induced tardive dystonia","authors":"Miwa Hagita ,&nbsp;Masaya Kubota","doi":"10.1016/j.bdcasr.2025.100068","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Dystonia is a movement disorder characterized by involuntary, sustained, or intermittent muscle contractions that often involve abnormalities in sensorimotor integration. Sensory tricks, in which a new sensory input can temporarily correct erroneous motor output, are hallmarks of dystonia. However, the underlying mechanism remains unclear. Here, we report a case of drug-induced tardive dystonia in which the sensory trick effect began <em>before</em> physical contact, providing new insights into its anticipatory processes.</div></div><div><h3>Case report</h3><div>A 17-year-old boy with intellectual disabilities, autism, and behavioral disorders developed torticollis and scoliosis after prolonged treatment with risperidone and levomepromazine. The symptoms included neck muscle co-contraction, leftward rotation, and compensatory scoliosis. A sensory trick was observed; light hand contact with the occiput improved the symptoms. However, the video analysis revealed that symptom relief began during arm movements <em>before</em> physical contact. This suggests the role of proprioception, motor preparation, and motor imagery in the sensory trick phenomenon. Discontinuation of the antipsychotics gradually resolved the symptoms.</div></div><div><h3>Conclusion</h3><div>This report highlights a crucial observation: sensory tricks begin before actual tactile contact, emphasizing the role of proprioceptive signals and motor planning in symptom relief. Anticipatory sensory processing suggests a broader mechanism that extends beyond tactile stimulation. These findings deepen our understanding of sensory tricks in dystonia and their neurophysiological basis, providing insights that could inform therapeutic strategies such as occupational therapy or biofeedback tailored to patients' self-discovered techniques for managing dystonia.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100068"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain and Development Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2950221725000078","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Dystonia is a movement disorder characterized by involuntary, sustained, or intermittent muscle contractions that often involve abnormalities in sensorimotor integration. Sensory tricks, in which a new sensory input can temporarily correct erroneous motor output, are hallmarks of dystonia. However, the underlying mechanism remains unclear. Here, we report a case of drug-induced tardive dystonia in which the sensory trick effect began before physical contact, providing new insights into its anticipatory processes.

Case report

A 17-year-old boy with intellectual disabilities, autism, and behavioral disorders developed torticollis and scoliosis after prolonged treatment with risperidone and levomepromazine. The symptoms included neck muscle co-contraction, leftward rotation, and compensatory scoliosis. A sensory trick was observed; light hand contact with the occiput improved the symptoms. However, the video analysis revealed that symptom relief began during arm movements before physical contact. This suggests the role of proprioception, motor preparation, and motor imagery in the sensory trick phenomenon. Discontinuation of the antipsychotics gradually resolved the symptoms.

Conclusion

This report highlights a crucial observation: sensory tricks begin before actual tactile contact, emphasizing the role of proprioceptive signals and motor planning in symptom relief. Anticipatory sensory processing suggests a broader mechanism that extends beyond tactile stimulation. These findings deepen our understanding of sensory tricks in dystonia and their neurophysiological basis, providing insights that could inform therapeutic strategies such as occupational therapy or biofeedback tailored to patients' self-discovered techniques for managing dystonia.
皮肤接触前开始的感觉障碍:药物引起的迟发性肌张力障碍的新观察
肌张力障碍是一种运动障碍,其特征是不自主的、持续的或间歇性的肌肉收缩,通常涉及感觉运动整合的异常。新的感觉输入可以暂时纠正错误的运动输出,这是肌张力障碍的标志。然而,其潜在机制尚不清楚。在这里,我们报告了一例药物引起的迟发性肌张力障碍,其中感觉欺骗效应在身体接触之前就开始了,为其预期过程提供了新的见解。病例报告一名患有智力障碍、自闭症和行为障碍的17岁男孩在长期使用利培酮和左旋丙嗪治疗后出现斜颈和脊柱侧凸。症状包括颈部肌肉共收缩、左旋和代偿性脊柱侧凸。观察到一种感官上的把戏;用手轻触枕部可改善症状。然而,视频分析显示,在身体接触之前,症状缓解始于手臂运动。这表明本体感觉、运动准备和运动意象在感觉欺骗现象中的作用。停用抗精神病药物后症状逐渐缓解。结论本报告强调了一个重要的观察结果:感觉技巧在实际触觉接触之前就开始了,强调了本体感觉信号和运动计划在症状缓解中的作用。预期感觉加工暗示了一种超越触觉刺激的更广泛的机制。这些发现加深了我们对肌张力障碍的感觉技巧及其神经生理学基础的理解,为治疗策略提供了见解,例如针对患者自我发现的管理肌张力障碍技术的职业治疗或生物反馈。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信