Cervical sensorimotor control in idiopathic cervical dystonia: A cross‐sectional study

• Published in: Brain and behavior Vol. 7; no. 9; pp. e00735 - n/a
• Main Authors: De Pauw, Joke, Mercelis, Rudy, Hallemans, Ann, Michiels, Sarah, Truijen, Steven, Cras, Patrick, De Hertogh, Willem
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.09.2017; John Wiley and Sons Inc
• Subjects: Adult; Aged; Aged, 80 and over; Botulinum toxin; Cross-Sectional Studies; Dystonia; FDA approval; Female; Head Movements - physiology; Humans; Male; Middle Aged; Neuromuscular diseases; Original Research; Physical therapy; position sense; Posture - physiology; proprioception; sensorimotor control; spasmodic torticollis; Spine; Torticollis - physiopathology; proprioception; spasmodic torticollis; position sense; dystonia; sensorimotor control
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.735

Objectives Patients 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 Methods Cervical 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. Results Patients 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. Conclusions Cervical 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. Cervical sensorimotor control was studied in 24 patients with cervical dystonia with a head repositioning accuracy test. Patients with cervical dystonia have larger joint repositioning errors indicating altered cervical sensorimotor control in cervical dystonia.