Spatial discrimination is abnormal in focal hand dystonia

Bara‐Jimenez, William; Shelton, Patricia; Hallett, Mark

doi:10.1212/wnl.55.12.1869

Cited by 183 publications

(118 citation statements)

References 25 publications

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“…Thus, our results predict that patients with dysfunctional basal ganglia and cerebellum should not only be impaired in temporal tasks but also in tasks involving spatial judgements (Gao et al, 1996;Weder et al, 1999;Bara-Jimenez et al, 2000;Molloy et al, 2003). Basal ganglia and cerebellar lesions could exert a more specific effect on timing function by disrupting their input to frontal cortex.…”

Section: Relationship To Lesion Studiesmentioning

confidence: 67%

The Functional Neuroanatomy of Temporal Discrimination

Pastor¹,

Day²,

Macaluso³

et al. 2004

J. Neurosci.

184

119

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Two identical stimuli, such as a pair of electrical shocks to the skin, are readily perceived as two separate events in time provided the interval between them is sufficiently long. However, as they are presented progressively closer together, there comes a point when the two separate stimuli are perceived as a single stimulus. Damage to posterior parietal cortex, peri-supplementary motor area (peri-SMA), and basal ganglia can disturb this form of temporal discrimination. Our aim was to establish, in healthy subjects, the brain areas that are involved in this process. During functional magnetic resonance imaging scanning, paired electrical pulses, separated by variable interstimulus intervals (5-110 msec), were delivered to different sites on one forearm (8 -64 mm from the midline). Subjects were required to simply detect the stimulus (control task) or to identify a stimulus property. For temporal discrimination (TD), subjects reported whether they felt one or two stimuli. For spatial discrimination, they reported whether the stimuli were located on the right or left side of the forearm. Subjects reported their choice by pressing a button with the opposite hand. Our results showed that discrimination, as opposed to simply detection, activated several brain areas. Most were common to both discrimination tasks. These included regions of prefrontal cortex, right postcentral gyrus and inferior parietal lobule, basal ganglia, and cerebellum. However, activation of pre-SMA and anterior cingulate was found to be specific to the TD task. This suggests that these two frontal regions may play a role in the temporal processing of somatosensory events.

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Section: Relationship To Lesion Studiesmentioning

confidence: 67%

The Functional Neuroanatomy of Temporal Discrimination

Pastor¹,

Day²,

Macaluso³

et al. 2004

J. Neurosci.

184

119

View full text Add to dashboard Cite

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“…22 A loss of spatial discrimination in the form of gap detection and single-touch localization has also been observed. 11 Rehabilitation techniques for patients with focal hand dystonia that include sensory discriminative training have been reported to improve sensorimotor function. 23,30,118 Findings of CNS reorganization associated with peripheral tissue injury and inflammation and with repetitive stereotyped movements have important implications in the rehabilitation of individuals with WMSDs.…”

Section: Evidence Of Cns Reorganization In Wmsdsmentioning

confidence: 99%

“…111 Corroborating evidence exists for central reorganization in patients with focal hand dystonia and includes changes in SEPs at all levels of the central neuroaxis, 22,27,43,110 as well as loss of spatial discrimination. 11 Such neuroplasticity interferes with normal sensation and movement, which may further increase the effects of continued exposure to repetitive tasks. …”

Section: Central Nervous System Reorganizationmentioning

confidence: 99%

Work-Related Musculoskeletal Disorders of the Hand and Wrist: Epidemiology, Pathophysiology, and Sensorimotor Changes

Barr

Barbe²,

Clark³

2004

J Orthop Sports Phys Ther

210

114

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The purpose of this commentary is to present recent epidemiological findings regarding work-related musculoskeletal disorders (WMSDs) of the hand and wrist, and to summarize experimental evidence of underlying tissue pathophysiology and sensorimotor changes in WMSDs. Sixty-five percent of the 333 800 newly reported cases of occupational illness in 2001 were attributed to repeated trauma. WMSDs of the hand and wrist are associated with the longest absences from work and are, therefore, associated with greater lost productivity and wages than those of other anatomical regions. Selected epidemiological studies of hand/wrist WMSDs published since 1998 are reviewed and summarized. Results from selected animal studies concerning underlying tissue pathophysiology in response to repetitive movement or tissue loading are reviewed and summarized. To the extent possible, corroborating evidence in human studies for various tissue pathomechanisms suggested in animal models is presented. Repetitive, handintensive movements, alone or in combination with other physical, nonphysical, and nonoccupational risk factors, contribute to the development of hand/wrist WMSDs. Possible pathophysiological mechanisms of tissue injury include inflammation followed by repair and/or fibrotic scarring, peripheral nerve injury, and central nervous system reorganization. Clinicians should consider all of these pathomechanisms when examining and treating patients with hand/wrist WMSDs.

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“…This view suggests that synchronous activation of several digits by vigorous and frequent musical practice leads to a disordered and smeared representation of the fingers in somatosensory and probably also in motor cortex, with the inability to move the most affected fingers separately (2,18). Also, sufficient evidence now exists to demonstrate a corresponding defective perception and abnormal sensory processing in focal hand dystonia (5,(19)(20)(21)(22). Given these abnormalities as well as the difficulties in currently available symptomatic treatments, new sensory and motor training programs have been developed and tested (3,4,23).…”

mentioning

confidence: 99%

Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

Candia

Wienbruch

Elbert

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

158

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New perspectives in neurorehabilitation suggest that behavioral treatments of movement disorders may modify the functional organization of central somatosensory neural networks. On the basis of the assumption that use-dependent reorganization in these networks contributes to the fundamental abnormalities seen in focal dystonia, we treated 10 affected musicians and measured the concomitant somatosensory changes by using whole-head magnetoencephalography. We found that effective treatment, using the method of sensory motor retuning, leads to alterations in the functional organization of the somatosensory cortex. Specifically, before treatment, somatosensory relationships of the individual fingers differ between the affected and unaffected hands, whereas after treatment, finger representations contralateral to the dystonic side become more similar to the less-affected side. Further, somatosensory finger representations are ordered more according to homuncular principles after treatment. In addition, the observed physiologic changes correlated with behavioral data. These results confirm that plastic changes in parallel with emergent neurological dysfunction may be reversed by contextspecific, intensive training-based remediation.

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Spatial discrimination is abnormal in focal hand dystonia

Abstract: These findings, together with a previously shown temporal discrimination deficit, support a role for sensory dysfunction in the pathophysiology of dystonia.

Cited by 183 publications

References 25 publications

The Functional Neuroanatomy of Temporal Discrimination

The Functional Neuroanatomy of Temporal Discrimination

Work-Related Musculoskeletal Disorders of the Hand and Wrist: Epidemiology, Pathophysiology, and Sensorimotor Changes

Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

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