Lateralization of the P22/N30 precentral cortical component of the median nerve somatosensory evoked potentials is different in patients with a tonic or tremulous form of cervical dystonia

Kaňovský, Petr; Streitová, Hana; Dufek, Jaroslav; Znojil, Vladimı́r; Daniel, Pavel; Rektor, Ivan

doi:10.1002/1531-8257(199907)14:4<642::aid-mds1014>3.0.co;2-m

Cited by 21 publications

(15 citation statements)

References 47 publications

(64 reference statements)

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“…We found both cortical functions significantly altered in patients with cervical dystonia. This fact only provides further evidence, following the recent similar findings of other authors [17,18,23,29,49,51,52,59] and of our previous studies involving SEP recordings [33,34,35]. SEP recordings in focal dystonia (and in other types of dystonic disorders) indicate that SEP changes can represent a disorder of cortical excitability in motor areas.…”

Section: Discussionsupporting

confidence: 85%

“…In light of our repeated findings in torticollis patients using SEP examinations [33][34][35], this is probably a similar finding, indicating that cortical abnormality is lateralized in rotational torticollis. It seems that both cortical excitability (reflected in abnormal SEP amplitudes) and intracortical inhibition (reflected in abnormal conditioned MEP responses) share the same lateralization pattern, i. e. they are both present (or at least more expressed) in the cortex of the hemisphere contralateral to the side of head deviation (should the direction of head deviation be expressed in terms of dystonic body involvement, it is the same side that is predominantly affected by dystonia).…”

Section: Discussionsupporting

confidence: 79%

“…SEP recordings in focal dystonia (and in other types of dystonic disorders) indicate that SEP changes can represent a disorder of cortical excitability in motor areas. This disorder seems to be lateralized, depending on the side of body involvement by dystonia [17,[33][34][35]. Our results in the examined group of twenty-one patients with rotational cervical dystonia provide further evidence of this.…”

Section: Discussionsupporting

confidence: 64%

“…The lateralized cortical involvement in dystonic disorders has been reported several times, using diverse methods of assessments: in our SEP studies [33][34][35]; in the study of Tinazzi et al, using tibial SEP recordings [59]; in the study of Naumann and Reiners, using longlatency reflex examination [42]; in the studies of Grünewald et al and Yoneda et al, where the tonic vibration reflex was studied [19,64]; and recently, in the study of Frasson et al, using conditioned median SEP recordings [17]. The lateralized abnormality, respective of the body side pattern of dystonia, was also found in Deuschl et al studies of movement related cortical potentials (MRCP) [14] and Ikeda et al and Hamano et al studies of contingent negative variation (CNV) [22,26].…”

Section: Discussionmentioning

confidence: 81%

“…Despite some early conflicting reports, this disorder has been found in several studies using somatosensory evoked potential recordings [17,29,49,59]. Our own studies have shown that this cortical disorder in dystonia is lateralized [33,34,35].…”

Section: Introductionmentioning

confidence: 83%

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Abnormalities of cortical excitability and cortical inhibition in cervical dystonia

Kaňovský¹,

Bareš²,

Streitová³

et al. 2003

Journal of Neurology

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Cortical excitability and cortico-cortical inhibition were examined in twenty-one patients suffering from idiopathic rotational cervical dystonia. Polymyography of cervical muscles, somatosensory evoked potential recordings, and paired transcranial magnetic stimulation were used to assess the dystonic disorder. The results were compared with those obtained in a group of sixteen healthy age-matched volunteers. Statistically significant differences between the patient group and the control group were found when the amplitude values of the mean P22/N30 component measured at F [3, 4] and C[3, 4]' electrode positions were compared. The mean amplitude of P22/N30 in both of these electrode positions contralaterally to the direction of head deviation was significantly higher in the patient group (p

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 83%

See 3 more Smart Citations

Abnormalities of cortical excitability and cortical inhibition in cervical dystonia

Kaňovský¹,

Bareš²,

Streitová³

et al. 2003

Journal of Neurology

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Dystonia: A disorder of motor programming or motor execution?

Kaňovský¹

2002

Movement Disorders

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For some time, dystonia has been seen as purely a motor disorder. Relatively novel concepts published approximately 10 years ago also presumed that in the development of dystonic dyskinesias, only motor behaviour was abnormal. Neurophysiological observations of various types of dystonic disorders, which were performed using sophisticated electromyography, polymyography, H-reflex examination, long-latency reflex, etc., as well as new insights into the behaviour of dystonia, have urged the inclusion of sensory (particularly somatosensory) mechanisms into the pathophysiological background of dystonia. The major role has been considered to be played by abnormal proprioceptive input by means of the Ia proprioceptive afferents, with the source of this abnormality found in the abnormal processing of muscle spindle afferent information. However, neurophysiological investigations have also provided evidence that the abnormality in the central nervous system is located not only at the spinal and subcortical level, but also at the cortical level; specifically, the cortical excitability and intracortical inhibition have been revealed as abnormal. This evidence was revealed by SEP recordings, paired transcranial magnetic stimulation recordings, and BP and CNV recordings. The current concept of dystonic movement connects the abnormal function of somatosensory pathways and somatosensory analysers with the dystonic performance of motor action, which is based on the abnormality of sensorimotor integration.

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Role of the somatosensory system in primary dystonia

2003

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The pathophysiology of dystonia is still not fully understood, but it is widely held that a dysfunction of the corticostriatal-thalamocortical motor circuits plays a major role in the pathophysiology of this syndrome. Although the most dramatic symptoms in dystonia seem to be motor in nature, marked somatosensory perceptual deficits are also present in this disease. In addition, several lines of evidence, including neurophysiological, neuroimaging and experimental findings, suggest that both motor and somatosensory functions may be defective in dystonia. Consequently, abnormal processing of the somatosensory input in the central nervous system may lead to inefficient sensorimotor integration, thus contributing substantially to the generation of dystonic movements. Whether somatosensory abnormalities are capable of triggering dystonia is an issue warranting further study. Although it seems unlikely that abnormal somatosensory input is the only drive to dystonia, it might be more correlated to the development of focal hand than generalized dystonia because local somesthetic factors are more selectively involved in the former than in the latter where, instead it seems to be a widespread deficit in processing sensory stimuli of different modality. Because basal ganglia and motor areas are heavily connected not only with somatosensory areas, but also with visual and acoustic areas, it is possible that abnormalities of other sensory modalities, such as visual and acoustic, may also be implicated in the pathophysiology of more severe forms of primary dystonia. Further studies have to be addressed to the assessment of the role of sensory modalities and their interaction on the pathophysiology of different forms of primary dystonia.

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Lateralization of the P22/N30 precentral cortical component of the median nerve somatosensory evoked potentials is different in patients with a tonic or tremulous form of cervical dystonia

Cited by 21 publications

References 47 publications

Abnormalities of cortical excitability and cortical inhibition in cervical dystonia

Abnormalities of cortical excitability and cortical inhibition in cervical dystonia

Dystonia: A disorder of motor programming or motor execution?

Role of the somatosensory system in primary dystonia

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