Abnormal effective connectivity in the sensory network in writer’s cramp

Tödt, Inken; Baumann, Alexander; Knutzen, Arne; Granert, Oliver; Tzvi, Elinor; Lindert, Julia; Wolff, Stephan; Witt, Karsten; Zeuner, Kirsten E.

doi:10.1016/j.nicl.2021.102761

Cited by 3 publications

(1 citation statement)

References 65 publications

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“…It is considered a motor network disorder including the sensorimotor cortex, basal ganglia, thalamus and cerebellum and provides a model for other forms of task specific dystonia areas (18)(19)(20)(21). Several studies demonstrated impaired sensory function (13,(22)(23)(24)(25)(26)(27), abnormal reorganization of the somatosensory cortex (S1) (28, 29) and sensorimotor integration (30) as result of maladaptive neural plasticity (31), alterations in motor planning with a lack of neuronal inhibition (13, 17), and cerebellar dysfunction (19,32,33). These areas are also involved during writing (34-36).…”

Section: Pathophysiology Of Writer's Crampmentioning

confidence: 99%

Treatment of writer’s cramp based on current pathophysiological concepts

Zeuner¹,

Baumann²,

Witt³

2023

Dystonia

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Task specific dystonia belongs to the group of focal dystonias. They are debilitating movement disorders that present with co-contraction of antagonist muscles during a specific task. The most common one is writer’s cramp. Botulinum toxin is the symptomatic standard treatment. Its response rate is 50% after 1 year, and the overall efficacy limited due to unwanted weakness in not injected muscles. The pathophysiology of writer’s cramp remains unclear, but genetic and additional environmental causes have been proposed. A possible underlying mechanism may be maladaptive reorganization in the sensorimotor cortex. Based on this background alternative treatment strategies were developed such as several different sensory and motor training programs that have been applied to reverse these brain abnormalities. In some studies, sensory and motor training were combined and adjunct with fitness exercises. They were conducted either as an outpatient setting or were established home based. Clinical outcome was measured with different clinical scales such as the writer’s cramp rating scale, the arm dystonia rating scale or the Burke, Fahn Marsden Scale. For objective assessment, kinematic handwriting parameters were analyzed. Functional or structural changes of the sensorimotor cortex were estimated using functional magnetic tomography, magnetencephalography and voxel-based morphometry. The results of these training programs were promising; however, one drawback is that the number of patients studied were small and the programs were not controlled since it is difficult to establish a control training to conduct a randomized controlled study.

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Section: Pathophysiology Of Writer's Crampmentioning

confidence: 99%

Treatment of writer’s cramp based on current pathophysiological concepts

Zeuner¹,

Baumann²,

Witt³

2023

Dystonia

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Zolpidem improves task-specific dystonia: A randomized clinical trial integrating exploratory transcranial magnetic stimulation and [18F] FDG-PET imaging

Vogelnik Žakelj,

Trošt,

Tomše

et al. 2024

Parkinsonism & Related Disorders

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Understanding Dystonia: A Summary of the Basics

Chisholm

2022

Australasian Journal of Neuroscience

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Dystonia is a neurological movement disorder characterised by abnormal and involuntary twisting movements and postures. It comes in many forms and can affect various parts of the body. Dystonia is seen in children and adults as a standalone condition, or as one part of a complex disease. Dystonia can be caused by genetic mutations, specific medications, environmental and chemical factors, or, as in the majority of cases, the cause is unknown. There is currently no cure or disease modifying agent for dystonia, so treatments are aimed at managing symptoms and maintaining quality of life. The treatment options for dystonia include invasive surgeries, medications, botulinum toxin and non-pharmaceutical therapies. Dystonia is often a misunderstood and misdiagnosed disorder, which makes diagnosis difficult. The diagnosis of dystonia is usually made by a Neurologist who specialises in Movement Disorders. Research is ongoing to better understand the disorder and aims to find more effective and efficient treatments, and ultimately a cure for dystonia.

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Abnormal effective connectivity in the sensory network in writer’s cramp

Abstract: Graphical abstract

Cited by 3 publications

References 65 publications

Treatment of writer’s cramp based on current pathophysiological concepts

Treatment of writer’s cramp based on current pathophysiological concepts

Zolpidem improves task-specific dystonia: A randomized clinical trial integrating exploratory transcranial magnetic stimulation and [18F] FDG-PET imaging

Understanding Dystonia: A Summary of the Basics

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