Spasticity, spastic dystonia, and static stretch reflex in hypertonic muscles of patients with multiple sclerosis

Puce, Luca; Currà, Antonio; Marinelli, Lucio; Mori, Laura; Capello, Elisabetta; Giovanni, Rachele Di; Bodrero, Matteo; Solaro, Claudio; Cotellessa, Filippo; Fattapposta, Francesco; Trompetto, Carlo

doi:10.1016/j.cnp.2021.05.002

Cited by 13 publications

(17 citation statements)

References 36 publications

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“…Trompetto and colleagues 18 found a higher prevalence of spastic dystonia in the flexor carpi radialis muscle of stroke patients exhibiting velocity dependent hypertonia (in a cohort of 23 such patients, 17 had spastic dystonia and 6 had spasticity only, i.e., were able to relax the muscle at will). Recently, Puce and colleagues 19 studied the electromyographic manifestations of hypertonic muscles in multiple sclerosis. EMG was recorded from muscles at rest, during stretch (dynamic stretch reflex) and during one minute immediately following muscle stretch (static stretch reflex).…”

Section: Introductionmentioning

confidence: 99%

“…EMG was recorded from muscles at rest, during stretch (dynamic stretch reflex) and during one minute immediately following muscle stretch (static stretch reflex). The expression of EMG activity in the three conditions differed in extensor and flexor muscles of the upper and lower limbs, providing novel insight into the heterogeneity of muscle hypertonia states in the upper motor neuron syndrome 19 .…”

Section: Introductionmentioning

confidence: 99%

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Shared and distinct voxel-based lesion-symptom mappings for spasticity and impaired movement in the hemiparetic upper limb

Frenkel‐Toledo

Levin

Berman

et al. 2022

Sci Rep

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Hemiparesis and spasticity are common co-occurring manifestations of hemispheric stroke. The relationship between impaired precision and force in voluntary movement (hemiparesis) and the increment in muscle tone that stems from dysregulated activity of the stretch reflex (spasticity) is far from clear. Here we aimed to elucidate whether variation in lesion topography affects hemiparesis and spasticity in a similar or dis-similar manner. Voxel-based lesion-symptom mapping (VLSM) was used to assess the impact of lesion topography on (a) upper limb paresis, as reflected by the Fugl-Meyer Assessment scale for the upper limb and (b) elbow flexor spasticity, as reflected by the Tonic Stretch Reflex Threshold, in 41 patients with first-ever stroke. Hemiparesis and spasticity were affected by damage to peri-Sylvian cortical and subcortical regions and the putamen. Hemiparesis (but not spasticity) was affected by damage to the corticospinal tract at corona-radiata and capsular levels, and by damage to white-matter association tracts and additional regions in the temporal cortex and pallidum. VLSM conjunction analysis showed only a minor overlap of brain voxels where the existence of damage affected both hemiparesis and spasticity, suggesting that control of voluntary movement and regulation of muscle tone at rest involve largely separate parts of the motor network.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Shared and distinct voxel-based lesion-symptom mappings for spasticity and impaired movement in the hemiparetic upper limb

Frenkel‐Toledo

Levin

Berman

et al. 2022

Sci Rep

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“…T sclerosis patients, i.e., spastic dystonia is evenly distributed between flexor and extensor muscles, whereas spasticity prevails in extensors (Marinelli et al, 2017;Puce et al, 2021).…”

Section: Athletementioning

confidence: 99%

“…In UMNS subjects, muscle hypertonia can be due to spasticity or spastic dystonia ( Trompetto et al, 2019a ) ( Puce et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers

et al. 2022

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In hypertonic muscles of patients with upper motor neuron syndrome (UMNS), investigation with surface electromyography (EMG) with the muscle in a shortened position and during passive muscle stretch allows to identify two patterns underlying hypertonia: spasticity and spastic dystonia. We recently observed in Para swimmers that the effect of fatigue on hypertonia can be different from subject to subject. Our goal was, therefore, to understand whether this divergent behavior may depend on the specific EMG pattern underlying hypertonia. We investigated eight UMNS Para swimmers (five men, mean age 23.25 ± 3.28 years), affected by cerebral palsy, who presented muscle hypertonia of knee flexors and extensors. Muscle tone was rated using the Modified Ashworth Scale (MAS). EMG patterns were investigated in rectus femoris (RF) and biceps femoris (BF) before and after two fatiguing motor tasks of increasing intensity. Before the fatiguing tasks, two subjects (#2 and 7) had spasticity and one subject (#5) had spastic dystonia in both RF and BF. Two subjects (#3 and 4) showed spasticity in RF and spastic dystonia in BF, whereas one subject (#1) had spasticity in RF and no EMG activity in BF. The remaining two subjects (#6 and 8) had spastic dystonia in RF and no EMG activity in BF. In all the 16 examined muscles, these EMG patterns persisted after the fatiguing tasks. Spastic dystonia increased (p < 0.05), while spasticity did not change (p > 0.05). MAS scores increased only in the muscles affected by spastic dystonia. Among the phenomena possibly underlying hypertonia, only spastic dystonia is fatigue-dependent. Technical staff and medical classifiers should be aware of this specificity, because, in athletes with spastic dystonia, intense and prolonged motor activity could negatively affect competitive performance, creating a situation of unfairness among Para athletes belonging to the same sports class.

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Spasticity patterns assessment and recognition for therapeutic approaches (SPARTA) in multiple sclerosis: a multicenter epidemiological study

De Blasiis,

Massimiani,

Inglese

et al. 2024

J Neurol

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Spasticity, spastic dystonia, and static stretch reflex in hypertonic muscles of patients with multiple sclerosis

Cited by 13 publications

References 36 publications

Shared and distinct voxel-based lesion-symptom mappings for spasticity and impaired movement in the hemiparetic upper limb

Shared and distinct voxel-based lesion-symptom mappings for spasticity and impaired movement in the hemiparetic upper limb

Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers

Spasticity patterns assessment and recognition for therapeutic approaches (SPARTA) in multiple sclerosis: a multicenter epidemiological study

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