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Brain, Vol. 119, No. 2, 569-583, 1996
© 1996 Oxford University Press


research-article

Impaired sensory–motor integration during grasping in writer’s cramp

T. Odergren1,, N. Iwasaki2, J. Borg1 and H. Forssberg2

1Departments of Neurology Stockholm, Sweden 2Woman and Child Health, Karolinska Hospital Stockholm, Sweden

Correspondence to: Correspondence to: Tomas Odergren, Department of Neurology, Karolinska Hospital, Box 130, S-171 76 Stockholm, Sweden

Six subjects with writer’s cramp and six healthy control subjects were examined while lifting a small instrumented object with variable weight and friction using the precision grip. The isometric grip and load forces were sampled at 400 Hz and stored in a flexible laboratory computer system for later analysis. Quantitative measurement of vibration and temperature sensibility showed normal sensory perception in the writer’s cramp subjects. They exhibited an impaired programming of the grip-lift force co-ordination, while the ability to generate unimodal force-rate trajectories and to characterize the pattern of the force output according to memory representations of weight and friction of the object were intact. The capacity to terminate quickly the programmed grip force in lifts erroneously programmed too high was impaired. Writer’s cramp subjects also employed excessive grip force during the static phase of the lift, and some patients had a short grip force latency after sudden unpredicted load increases, indicating a disinhibited spinal reflex response. The results indicate an impaired capacity in writer’s cramp subjects to integrate sensory information in the motor programming and force regulation during precision grip tasks, despite a normal sensibility.

writer’s cramp; dystonia; sensory-motor integration; precision grip

Received September 25, 1995. Accepted November 6, 1995.


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