Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Nov;59(5):493–498. doi: 10.1136/jnnp.59.5.493

Changes in the balance between motor cortical excitation and inhibition in focal, task specific dystonia.

M C Ridding 1, G Sheean 1, J C Rothwell 1, R Inzelberg 1, T Kujirai 1
PMCID: PMC1073711  PMID: 8530933

Abstract

Transcranial magnetic stimulation has been used in a double pulse paradigm to investigate the excitability of intrinsic motor cortical circuits in 15 patients with focal task specific dystonia of the right hand and a group of eight age matched controls. The left hemisphere was examined in five patients; in the remainder, both hemispheres were tested. There was no significant difference in stimulation threshold between patients and controls nor between the left and right hemispheres in the patients. There was a significant decrease in early corticocortical suppression when comparing stimulation of the left hemisphere in the patients and controls at interstimulus intervals of 1-15 ms (P < 0.01). There was no difference in the amount of suppression in the right and left hemispheres of the patients. It is concluded that in focal task specific dystonia there is shift in the balance between excitation and inhibition in local circuits of the motor cortex which leads to a net decrease in the amount of short latency suppression. These changes reflect disturbed basal ganglia input to the motor cortex. Reduced excitability of cortical inhibitory circuits may be one factor which contributes to the excessive and inappropriate muscle contraction which occurs during fine motor tasks in patients with focal dystonia.

Full text

PDF
493

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berardelli A., Rothwell J. C., Day B. L., Marsden C. D. Pathophysiology of blepharospasm and oromandibular dystonia. Brain. 1985 Sep;108(Pt 3):593–608. doi: 10.1093/brain/108.3.593. [DOI] [PubMed] [Google Scholar]
  2. Day B. L., Dressler D., Maertens de Noordhout A., Marsden C. D., Nakashima K., Rothwell J. C., Thompson P. D. Electric and magnetic stimulation of human motor cortex: surface EMG and single motor unit responses. J Physiol. 1989 May;412:449–473. doi: 10.1113/jphysiol.1989.sp017626. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Fève A., Bathien N., Rondot P. Abnormal movement related potentials in patients with lesions of basal ganglia and anterior thalamus. J Neurol Neurosurg Psychiatry. 1994 Jan;57(1):100–104. doi: 10.1136/jnnp.57.1.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kujirai T., Caramia M. D., Rothwell J. C., Day B. L., Thompson P. D., Ferbert A., Wroe S., Asselman P., Marsden C. D. Corticocortical inhibition in human motor cortex. J Physiol. 1993 Nov;471:501–519. doi: 10.1113/jphysiol.1993.sp019912. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Matsumura M., Sawaguchi T., Kubota K. GABAergic inhibition of neuronal activity in the primate motor and premotor cortex during voluntary movement. J Neurophysiol. 1992 Sep;68(3):692–702. doi: 10.1152/jn.1992.68.3.692. [DOI] [PubMed] [Google Scholar]
  6. Nakashima K., Rothwell J. C., Day B. L., Thompson P. D., Shannon K., Marsden C. D. Reciprocal inhibition between forearm muscles in patients with writer's cramp and other occupational cramps, symptomatic hemidystonia and hemiparesis due to stroke. Brain. 1989 Jun;112(Pt 3):681–697. doi: 10.1093/brain/112.3.681. [DOI] [PubMed] [Google Scholar]
  7. Nakashima K., Rothwell J. C., Thompson P. D., Day B. L., Berardelli A., Agostino R., Artieda J., Papas S. M., Obeso J. A., Marsden C. D. The blink reflex in patients with idiopathic torsion dystonia. Arch Neurol. 1990 Apr;47(4):413–416. doi: 10.1001/archneur.1990.00530040055019. [DOI] [PubMed] [Google Scholar]
  8. Panizza M. E., Hallett M., Nilsson J. Reciprocal inhibition in patients with hand cramps. Neurology. 1989 Jan;39(1):85–89. doi: 10.1212/wnl.39.1.85. [DOI] [PubMed] [Google Scholar]
  9. Priori A., Berardelli A., Mercuri B., Manfredi M. Physiological effects produced by botulinum toxin treatment of upper limb dystonia. Changes in reciprocal inhibition between forearm muscles. Brain. 1995 Jun;118(Pt 3):801–807. doi: 10.1093/brain/118.3.801. [DOI] [PubMed] [Google Scholar]
  10. Reilly J. A., Hallett M., Cohen L. G., Tarkka I. M., Dang N. The N30 component of somatosensory evoked potentials in patients with dystonia. Electroencephalogr Clin Neurophysiol. 1992 May-Jun;84(3):243–247. doi: 10.1016/0168-5597(92)90005-v. [DOI] [PubMed] [Google Scholar]
  11. Ridding M. C., Inzelberg R., Rothwell J. C. Changes in excitability of motor cortical circuitry in patients with Parkinson's disease. Ann Neurol. 1995 Feb;37(2):181–188. doi: 10.1002/ana.410370208. [DOI] [PubMed] [Google Scholar]
  12. Sheehy M. P., Rothwell J. C., Marsden C. D. Writer's cramp. Adv Neurol. 1988;50:457–472. [PubMed] [Google Scholar]
  13. Tempel L. W., Perlmutter J. S. Abnormal cortical responses in patients with writer's cramp. Neurology. 1993 Nov;43(11):2252–2257. doi: 10.1212/wnl.43.11.2252. [DOI] [PubMed] [Google Scholar]
  14. Tolosa E., Montserrat L., Bayes A. Blink reflex studies in focal dystonias: enhanced excitability of brainstem interneurons in cranial dystonia and spasmodic torticollis. Mov Disord. 1988;3(1):61–69. doi: 10.1002/mds.870030108. [DOI] [PubMed] [Google Scholar]
  15. Ugawa Y., Hanajima R., Kanazawa I. Motor cortex inhibition in patients with ataxia. Electroencephalogr Clin Neurophysiol. 1994 Jun;93(3):225–229. doi: 10.1016/0168-5597(94)90044-2. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES