Clinical significance of indicators of energy metabolism in muscles involved in dystonic hyperkinesis in patients with idiopathic muscular dystonia

Abstract

Introduction. Dystonia is a syndrome with location of pathological mechanisms in the central nervous system. The clinical manifestation of the syndrome is dystonic hyperkinesis with the formation of increased muscle tone, which may be associated with changes in cellular metabolism. Aim is to evaluate the indicators of energy metabolism in the muscles involved in dystonic hyperkinesis and compare with the severity of dystonia in patients with idiopathic muscular dystonia.
 Materials and methods. There were examined eighty four patients diagnosed with idiopathic muscular dystonia, including 17 men (20.2%) and 67 women (79.8%). In 38 cases there was cervical muscular dystonia, 36 and 10 cases showed segmental and generalized forms of dystonia with predominance of cervical dystonia syndrome, respectively. The average age of patients was 46 ± 11 among men and 52 ± 11 among women. The control group included 10 conditionally healthy individuals with an average age of 53.0 ± 13.4 years. The severity of cervical dystonia was assessed by the TWSTRS and Tsui scales. All participants of the study underwent biopsy sampling from the trapezius muscle, followed by determination of the level of ATP (adenosine triphosphoric acid), lactate and 2,3 DPH (2,3-diphosphoglyceric acid).
 Results. The results of the study revealed changes in the bioenergetics of muscle tissue in the form of a decrease in ATP and 2,3-DPH and an increase in lactate levels that did not correlate with the severity of dystonia on the TWSTRS and Tsui scales.
 Conclusion. Thus, bioenergetic changes in muscle tissue are not associated with the severity of dystonia and probably reflect general changes in the organization of intracellular energy metabolism in muscles in a hypertonic state.