Brain, Vol. 123, No. 1, 42-50,
January 2000
© 2000 Oxford University Press
Abnormal central integration of a dual somatosensory input in dystonia
Evidence for sensory overflow
1 Dipartimento di Scienze Neurologiche e della Visione, Sez. di Neurologia Riabilitativa, Verona, 2 Clinica Neurologica, Università di Milano, Ospedale Maggiore Policlinico Milano and IRCCS Centro S. Giovanni di Dio, Brescia, Italy and 3 Functional Neurology and Epileptology Department, Hopital Neurologique, Lyon, France
Correspondence to:
Michele Tinazzi, Dipartimento di Scienze Neurologiche e della Visione, Sez. di Neurologia Riabilitativa, Via delle Menegone, 6 37134 Verona, Italy
Several observations suggest impaired central sensory integration in dystonia. We studied median and ulnar nerve somatosensory evoked potentials (SEPs) in 10 patients who had dystonia involving at least one upper limb (six had generalized, two had segmental and two had focal dystonia) and in 10 normal subjects. We compared the amplitude of spinal N13, brainstem P14, parietal N20 and P27 and frontal N30 SEPs obtained by stimulating the median and ulnar nerves simultaneously (MU), the amplitude value being obtained from the arithmetic sum of the SEPs elicited by stimulating the same nerves separately (M + U). Throughout the somatosensory system, the MU : (M + U) ratio indicates the interaction between afferent inputs from the two peripheral nerves. No significant difference was found between SEP amplitudes and latencies for individually stimulated median and ulnar nerves in dystonic patients and normal subjects, but recordings in patients yielded a significantly higher percentage ratio [MU : (M + U)x100] for spinal N13 brainstem P14 and cortical N20, P27 and N30 components. The SEP ratio of central components obtained in response to stimulation of the digital nerves of the third and fifth fingers was also higher in patients than in controls but the difference did not reach a significant level. The possible contribution of subliminal activation was ruled out by recording the ratio of SEPs in six normal subjects during voluntary contraction. This voluntary contraction did not change the ratio of SEP suppression. These findings suggest that the inhibitory integration of afferent inputs, mainly proprioceptive inputs, coming from adjacent body parts is abnormal in dystonia. This inefficient integration, which is probably due to altered surrounding inhibition, could give rise to an abnormal motor output and might therefore contribute to the motor impairment present in dystonia.
upper limb SEPs; somatosensory evoked potentials; dystonia; somatosensory system; muscle afferent input; surrounding inhibition
M = median nerve; SEP = somatosensory evoked potential; U = ulnar nerve
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Foffani, J. K. Chapin, and K. A. Moxon Computational Role of Large Receptive Fields in the Primary Somatosensory Cortex J Neurophysiol, July 1, 2008; 100(1): 268 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. F. Chang, R. S. Turner, J. L. Ostrem, V. R. Davis, and P. A. Starr Neuronal Responses to Passive Movement in the Globus Pallidus Internus in Primary Dystonia J Neurophysiol, December 1, 2007; 98(6): 3696 - 3707. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. Yoon, P. H. Lee, and S. N. Yoon Subtraction Brain SPECT Imaging in a Patient With Paroxysmal Exercise-Induced Dystonia: Role of the Primary Somatosensory Cortex Arch Neurol, November 1, 2007; 64(11): 1652 - 1656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Defazio, A. Berardelli, and M. Hallett Do primary adult-onset focal dystonias share aetiological factors? Brain, May 1, 2007; 130(5): 1183 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Cimatti, D. P Schwartz, F. Bourdain, S. Meunier, J.-P. Bleton, M. Vidailhet, B. Renault, and L. Garnero Time-frequency analysis reveals decreased high-frequency oscillations in writer's cramp Brain, January 1, 2007; 130(1): 198 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Peller, K. E. Zeuner, A. Munchau, A. Quartarone, M. Weiss, A. Knutzen, M. Hallett, G. Deuschl, and H. R. Siebner The basal ganglia are hyperactive during the discrimination of tactile stimuli in writer's cramp Brain, October 1, 2006; 129(10): 2697 - 2708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Weise, A. Schramm, K. Stefan, A. Wolters, K. Reiners, M. Naumann, and J. Classen The two sides of associative plasticity in writer's cramp Brain, October 1, 2006; 129(10): 2709 - 2721. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Etgen, M Muhlau, C Gaser, and D Sander Bilateral grey-matter increase in the putamen in primary blepharospasm J. Neurol. Neurosurg. Psychiatry, September 1, 2006; 77(9): 1017 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Fiorio, M. Tinazzi, and S. M. Aglioti Selective impairment of hand mental rotation in patients with focal hand dystonia Brain, January 1, 2006; 129(1): 47 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Di Lazzaro, F. Pilato, M. Dileone, P. A. Tonali, and U. Ziemann Dissociated effects of diazepam and lorazepam on short-latency afferent inhibition J. Physiol., November 15, 2005; 569(1): 315 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Rosenkranz, A. Williamon, K. Butler, C. Cordivari, A. J. Lees, and J. C. Rothwell Pathophysiological differences between musician's dystonia and writer's cramp Brain, April 1, 2005; 128(4): 918 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Pullman and A. H. Hristova Musician's dystonia Neurology, January 25, 2005; 64(2): 186 - 187. [Full Text] [PDF]
|
|
|
|
|
|
N. Murase, J. C. Rothwell, R. Kaji, R. Urushihara, K. Nakamura, N. Murayama, T. Igasaki, M. Sakata-Igasaki, T. Mima, A. Ikeda, et al. Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer's cramp Brain, January 1, 2005; 128(1): 104 - 115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Quartarone, S. Bagnato, V. Rizzo, H. R. Siebner, V. Dattola, A. Scalfari, F. Morgante, F. Battaglia, M. Romano, and P. Girlanda Abnormal associative plasticity of the human motor cortex in writer's cramp Brain, December 1, 2003; 126(12): 2586 - 2596. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. Molloy, T. D. Carr, K. E. Zeuner, J. M. Dambrosia, and M. Hallett Abnormalities of spatial discrimination in focal and generalized dystonia Brain, October 1, 2003; 126(10): 2175 - 2182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Aglioti, M. Fiorio, B. Forster, and M. Tinazzi Temporal discrimination of cross-modal and unimodal stimuli in generalized dystonia Neurology, March 11, 2003; 60(5): 782 - 785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Tamburin and G Zanette Focal hand dystonia after cervical whiplash injury J. Neurol. Neurosurg. Psychiatry, January 1, 2003; 74(1): 134 - 134. [Full Text] [PDF]
|
|
|
|
|
|
F. Hummel, F. Andres, E. Altenmuller, J. Dichgans, and C. Gerloff Inhibitory control of acquired motor programmes in the human brain Brain, February 1, 2002; 125(2): 404 - 420. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Munchau, C D Good, S McGowan, N P Quinn, J D Palmer, and K P Bhatia Prospective study of swallowing function in patients with cervical dystonia undergoing selective peripheral denervation J. Neurol. Neurosurg. Psychiatry, July 1, 2001; 71(1): 67 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Abbruzzese, R. Marchese, A. Buccolieri, B. Gasparetto, and C. Trompetto Abnormalities of sensorimotor integration in focal dystonia: A transcranial magnetic stimulation study Brain, March 1, 2001; 124(3): 537 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tinazzi, A. Fiaschi, T. Rosso, F. Faccioli, J. Grosslercher, and S. M. Aglioti Neuroplastic Changes Related to Pain Occur at Multiple Levels of the Human Somatosensory System: A Somatosensory-Evoked Potentials Study in Patients with Cervical Radicular Pain J. Neurosci., December 15, 2000; 20(24): 9277 - 9283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Sanger and M. M. Merzenich Computational Model of the Role of Sensory Disorganization in Focal Task-Specific Dystonia J Neurophysiol, November 1, 2000; 84(5): 2458 - 2464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Murase, R. Kaji, H. Shimazu, M. Katayama-Hirota, A. Ikeda, N. Kohara, J. Kimura, H. Shibasaki, and J. C. Rothwell Abnormal premovement gating of somatosensory input in writer's cramp Brain, September 1, 2000; 123(9): 1813 - 1829. [Abstract] [Full Text] [PDF]
|
|