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Brain, Vol. 123, No. 9, 1765-1766, September 2000
© 2000 Oxford University Press


Editorial

Disorder of movement preparation in dystonia

Mark Hallett, MD

Human Motor Control Section, NINDS, National Institutes of Health Bethesda, MD, USA

Dystonia is undoubtedly characterized by a disorder of movement execution. In many patients, the `involuntary movements' are brought about entirely by attempted voluntary movement. Only in more severe cases are there truly involuntary movements, but even they are exacerbated by volition. The EMG pattern underlying movement demonstrates too much motor activation. There is excessive activation of antagonists, overflow into synergists, unnecessarily activated muscles and prolongation of muscle activation. Such activation gives rise to abnormal muscle spasms and incoordination.

A number of recent studies seem to indicate that excessive muscle activation is due to a deficiency of inhibition (Berardelli et al., 1998Go; Hallett, 1998Go). . . . [Full Text of this Article]

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