Abstract
Botulinum toxin (BoNT) injections in the dystonic muscles is the preferred treatment for Cervical Dystonia (CD), but the proper identification of the dystonic muscles remains a challenge. Previous studies showed decreased 8–14 Hz autospectral power in the electromyography (EMG) of splenius muscles in CD patients. Cumulative distribution functions (CDF’s) of dystonic muscles showed increased CDF10 values, representing increased autospectral powers between 3 and 10 Hz, relative to power between 3 and 32 Hz. In this study, we evaluated both methods and investigated the effects of botulinum toxin. Intramuscular EMG recordings were obtained from the splenius, semispinalis, and sternocleidomastoid muscles during standardized isometric tasks in 4 BoNT-naïve CD patients, 12 BoNT-treated patients, and 8 healthy controls. BoNT-treated patients were measured 4–7 weeks after their last BoNT injections and again after 11–15 weeks. We found significantly decreased 8–14 Hz autospectral power in splenius muscles, but not in the semispinalis and sternocleidomastoid muscles of CD patients when compared to healthy controls. CDF10 analysis was superior in demonstrating subtle autospectral changes, and showed increased CDF10 values in all studied muscles of CD patients. These results did not change significantly after BoNT injections. Further studies are needed to investigate the origin of these autospectral changes in dystonia patients, and to assess their potential in muscle selection for BoNT treatment.
Highlights
Dystonia is a syndrome characterized by sustained or intermittent involuntary muscle contractions, leading to debilitating abnormal postures and twisting movements [1]
Intramuscular EMG recordings were obtained during standardized isometric tasks to investigate
CDF10 valuesduring in cervical dystonia (CD) patients when compared to healthy controls
Summary
Dystonia is a syndrome characterized by sustained or intermittent involuntary muscle contractions, leading to debilitating abnormal postures and twisting movements [1]. In cervical dystonia (CD), the most common form of primary dystonia, the neck muscles are primarily involved [2]. The first line treatment for CD is botulinum toxin (BoNT) injection in the dystonic muscles [3]. For an optimal treatment effect, proper selection of the dystonic muscles is essential [4,5]. No specific tools are available to reliably identify dystonic muscles, and discriminate them from healthy compensating muscles [6]. In a previous study we obtained intramuscular electromyography (EMG)
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