Abstract
ObjectivesPatients with idiopathic adult‐onset cervical dystonia (CD) experience an abnormal head posture and involuntary muscle contractions. Although the exact areas affected in the central nervous system remain uncertain, impaired functions in systems stabilizing the head and neck are apparent such as the somatosensory and sensorimotor integration systems. The aim of the study is to investigate cervical sensorimotor control dysfunction in patients with CD.Material and MethodsCervical sensorimotor control was assessed by a head repositioning task in 24 patients with CD and 70 asymptomatic controls. Blindfolded participants were asked to reposition their head to a previously memorized neutral head position (NHP) following an active movement (flexion, extension, left, and right rotation). The repositioning error (joint position error, JPE) was registered via 3D motion analysis with an eight‐camera infrared system (VICON ® T10). Disease‐specific characteristics of all patients were obtained via the Tsui scale, Cervical Dystonia Impact Profile (CDIP‐58), and Toronto Western Spasmodic Rating Scale.ResultsPatients with CD showed larger JPE than controls (mean difference of 1.5°, p < .006), and systematically ‘overshoot’, i.e. surpassed the NHP, whereas control subjects ‘undershoot’, i.e. fall behind the NHP. The JPE did not correlate with disease‐specific characteristics.ConclusionsCervical sensorimotor control is impaired in patients with CD. As cervical sensorimotor control can be trained, this might be a potential treatment option for therapy, adjuvant to botulinum toxin injections.
Highlights
Adult-onset idiopathic cervical dystonia (CD) is a movement disorder which is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both
We focus on cervical sensorimotor control
Intergroup differences were calculated by means of independent samples T-test for normally distributed variables and a Mann–Whitney U test for nonnormally distributed variables
Summary
Adult-onset idiopathic cervical dystonia (CD) is a movement disorder which is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both. Dystonic movements are typically patterned, twisting and may be tremulous and is frequently accompanied by pain (Albanese et al, 2011; Jinnah & Albanese, 2014). It is the most common form of focal dystonia with a prevalence in Europe ranging from 44 to 183 cases per million (Defazio, Jankovic, Giel, & Papapetropoulos, 2013). The cause of CD remains unknown but in addition to motor symptoms CD is associated with nonmotor symptoms such as sensory Treatment of choice is injections with botulinum toxin (Albanese et al, 2011) and physical therapy is often used as an adjuvant therapy (De Pauw et al, 2014).
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