The role of cerebellum in patients with late onset cervical/segmental dystonia?–Evidence from the clinic

Batla, Amit; Sánchez, María del Carmen Romero; Erro, Roberto; Ganos, Christos; Stamelou, María; Balint, Bettina; Brugger, Florian; Antelmi, Elena; Bhatia, Kailash P.

doi:10.1016/j.parkreldis.2015.09.013

Cited by 59 publications

(40 citation statements)

References 30 publications

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“…These studies indicate that majority of secondary cases of CD are associated structural lesions of the brainstem and cerebellum, with lesions in the cervical spinal cord and basal ganglia being observed less frequently [33–43]. Despite being inconsistent, head rotation tended to be contralateral to the side of the lesion.…”

Section: Reviewmentioning

confidence: 99%

Cerebellum: An explanation for dystonia?

Bologna

Berardelli

2017

cerebellum ataxias

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Dystonia is a movement disorder that is characterized by involuntary muscle contractions, abnormal movements and postures, as well as by non-motor symptoms, and is due to abnormalities in different brain areas. In this article, we focus on the growing number of experimental studies aimed at explaining the pathophysiological role of the cerebellum in dystonia. Lastly, we highlight gaps in current knowledge and issues that future research studies should focus on as well as some of the potential applications of this research avenue. Clarifying the pathophysiological role of cerebellum in dystonia is an important concern given the increasing availability of invasive and non-invasive stimulation techniques and their potential therapeutic role in this condition.

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Section: Reviewmentioning

confidence: 99%

Cerebellum: An explanation for dystonia?

Bologna

Berardelli

2017

cerebellum ataxias

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“…In one study, 9 % of patients with segmental and cervical dystonia were found to have cerebellar atrophy [138]. The spinocerebellar ataxias (SCA) are known to have structural atrophy and degeneration of the cerebellum.…”

Section: What Does Brain Structure In Human Dystonia Tell Us About a mentioning

confidence: 99%

“…The spinocerebellar ataxias (SCA) are known to have structural atrophy and degeneration of the cerebellum. Dystonia may be a presenting clinical feature of SCA [138] with up to 9 % of SCA2 patients reported to have dystonia at presentation [139, 140]. SCA17, SCA3, and other SCAs [141] are also commonly associated with dystonia.…”

Section: What Does Brain Structure In Human Dystonia Tell Us About a mentioning

confidence: 99%

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Current Opinions and Areas of Consensus on the Role of the Cerebellum in Dystonia

et al. 2016

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A role for the cerebellum in causing ataxia, a disorder characterized by uncoordinated movement, is widely accepted. Recent work has suggested that alterations in activity, connectivity, and structure of the cerebellum are also associated with dystonia, a neurological disorder characterized by abnormal and sustained muscle contractions often leading to abnormal maintained postures. In this manuscript, the authors discuss their views on how the cerebellum may play a role in dystonia. The following topics are discussed: The relationships between neuronal/network dysfunctions and motor abnormalities in rodent models of dystonia.Data about brain structure, cerebellar metabolism, cerebellar connections, and noninvasive cerebellar stimulation that support (or not) a role for the cerebellum in human dystonia.Connections between the cerebellum and motor cortical and sub-cortical structures that could support a role for the cerebellum in dystonia. Overall points of consensus include: Neuronal dysfunction originating in the cerebellum can drive dystonic movements in rodent model systems.Imaging and neurophysiological studies in humans suggest that the cerebellum plays a role in the pathophysiology of dystonia, but do not provide conclusive evidence that the cerebellum is the primary or sole neuroanatomical site of origin.

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“…Neuropathological examinations in post-mortem brain tissue of patients with cervical dystonia (CD) reveal Purkinje cell degeneration, areas of focal gliosis and torpedo bodies (Prudente et al, 2013). Clinical observations also indicate that focal dystonia may be associated with structural lesions of the cerebellum and its afferent pathways (LeDoux and Brady 2003; Batla et al, 2015). Moreover, neuroimaging studies using various techniques have provided evidence of cerebellar grey matter changes and altered cerebello-thalamo-cortical pathways in patients with focal hand dystonia (FHD) or CD (Draganski et al, 2003; Delmaire et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Effects of cerebellar theta-burst stimulation on arm and neck movement kinematics in patients with focal dystonia

Bologna

Paparella

Fabbrini

et al. 2016

Clinical Neurophysiology

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Objective To investigate the cerebellar inhibitory influence on the primary motor cortex in patients with focal dystonia using a cerebellar continuous theta-burst stimulation protocol (cTBS) and to evaluate any relationship with movement abnormalities. Methods Thirteen patients with focal hand dystonia, 13 patients with cervical dystonia and 13 healthy subjects underwent two sessions: (i) cTBS over the cerebellar hemisphere (real cTBS) and (ii) cTBS over the neck muscles (sham cTBS). The effects of cerebellar cTBS were quantified as excitability changes in the contralateral primary motor cortex, as well as possible changes in arm and neck movements in patients. Results Real cerebellar cTBS reduced the excitability in the contralateral primary motor cortex in healthy subjects and in patients with cervical dystonia, though not in patients with focal hand dystonia. There was no correlation between changes in primary motor cortex excitability and arm and neck movement kinematics in patients. There were no changes in clinical scores or in kinematic measures, after either real or sham cerebellar cTBS in patients. Conclusions The reduced cerebellar inhibitory modulation of primary motor cortex excitability in focal dystonia may be related to the body areas affected by dystonia as opposed to being a widespread pathophysiological abnormality. Significance The present study yields information on the differential role played by the cerebellum in the pathophysiology of different focal dystonias.

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The role of cerebellum in patients with late onset cervical/segmental dystonia?–Evidence from the clinic

Cited by 59 publications

References 30 publications

Cerebellum: An explanation for dystonia?

Cerebellum: An explanation for dystonia?

Current Opinions and Areas of Consensus on the Role of the Cerebellum in Dystonia

Effects of cerebellar theta-burst stimulation on arm and neck movement kinematics in patients with focal dystonia

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