High frequency somatosensory stimulation in dystonia: Evidence fordefective inhibitory plasticity
High frequency somatosensory stimulation in dystonia: Evidence fordefective inhibitory plasticity
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DOI：
10.1002/mds.27470
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发表时间：
2018-12-01
影响因子：
8.6
通讯作者：
Bhatia, Kailash P.
中科院分区：
文献类型：
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作者：
Erro, Roberto;Rocchi, Lorenzo;Bhatia, Kailash P.
背景 除了运动症状外，肌张力障碍还表现出多种感觉处理缺陷。最一致的行为测量是异常的体感时间辨别阈值，最近它与初级体感区域抑制减少的生理测量相关。高频重复感觉刺激是一种通过表面电极施加到皮肤的图案化电刺激，最近有报道称，它可以缩短健康受试者的体感时间辨别力，并提高体感甚至运动区域几种不同类型的抑制性相互作用的静息兴奋性水平。目的 我们测试高频重复感觉刺激是否可以增强皮质抑制，进而改善颈肌张力障碍的体感时间辨别力。方法 在 45 分钟高频重复感觉刺激之前和之后测量体感时间辨别以及感觉运动抑制和促进的一些电生理测量。结果与一组年龄相仿的健康志愿者相比，高频重复感觉刺激增加了抑制并缩短了体感时间辨别力，颈肌张力障碍患者表现出一致的、矛盾的反应：他们减少了对成对脉冲体感诱发电位的抑制，并减少了高频振荡、侧向抑制和短间隔皮质内抑制。刺激方案后体感时间辨别力恶化，并与初级体感皮层内抑制措施的减少相关。结论 我们认为肌张力障碍患者感觉运动皮层内具有异常的稳态抑制可塑性，这就是他们对高频重复感觉刺激的矛盾反应的原因。 (c) 2018年国际帕金森与运动障碍学会
Background Apart from motor symptoms, multiple deficits of sensory processing have been demonstrated in dystonia. The most consistent behavioural measure of this is abnormal somatosensory temporal discrimination threshold, which has recently been associated with physiological measures of reduced inhibition within the primary somatosensory area. High-frequency repetitive sensory stimulation is a patterned electric stimulation applied to the skin through surface electrodes that has been recently reported to shorten somatosensory temporal discrimination in healthy subjects and to increase the resting level of excitability in several different types of inhibitory interaction in the somatosensory and even motor areas. Objectives We tested whether high-frequency repetitive sensory stimulation could augment cortical inhibition and, in turn, ameliorate somatosensory temporal discrimination in cervical dystonia. Methods Somatosensory temporal discrimination and a number of electrophysiological measures of sensorimotor inhibition and facilitation were measured before and after 45 minutes of high-frequency repetitive sensory stimulation. Results As compared with a group of healthy volunteers of similar age, in whom high-frequency repetitive sensory stimulation increased inhibition and shortened somatosensory temporal discrimination, patients with cervical dystonia showed a consistent, paradoxical response: they had reduced suppression of paired-pulse somatosensory evoked potentials, as well as reduced high-frequency oscillations, lateral inhibition, and short interval intracortical inhibition. Somatosensory temporal discrimination deteriorated after the stimulation protocol, and correlated with reduced measures of inhibition within the primary somatosensory cortex. Conclusions We suggest that patients with dystonia have abnormal homeostatic inhibitory plasticity within the sensorimotor cortex and that this is responsible for their paradoxical response to high-frequency repetitive sensory stimulation. (c) 2018 International Parkinson and Movement Disorder Society