Journal Article

Abnormal sensorimotor plasticity in organic but not in psychogenic dystonia

A. Quartarone, V. Rizzo, C. Terranova, F. Morgante, S. Schneider, N. Ibrahim, P. Girlanda, K. P. Bhatia and J. C. Rothwell

in Brain

Published on behalf of The Guarantors of Brain

Volume 132, issue 10, pages 2871-2877
Published in print October 2009 | ISSN: 0006-8950
Published online August 2009 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awp213
Abnormal sensorimotor plasticity in organic but not in psychogenic dystonia

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Dystonia is characterized by two main pathophysiological abnormalities: ‘reduced’ excitability of inhibitory systems at many levels of the sensorimotor system, and ‘increased’ plasticity of neural connections in sensorimotor circuits at a brainstem and spinal level. A surprising finding in two recent papers has been the fact that abnormalities of inhibition similar to those in organic dystonia are also seen in patients who have psychogenic dystonia. To try to determine the critical feature that might separate organic and psychogenic conditions, we investigated cortical plasticity in a group of 10 patients with psychogenic dystonia and compared the results with those obtained in a matched group of 10 patients with organic dystonia and 10 healthy individuals. We confirmed the presence of abnormal motor cortical inhibition (short-interval intracortical inhibition) in both organic and psychogenic groups. However, we found that plasticity (paired associative stimulation) was abnormally high only in the organic group, while there was no difference between the plasticity measured in psychogenic patients and healthy controls. We conclude that abnormal plasticity is a hallmark of organic dystonia; furthermore it is not a consequence of reduced inhibition since the latter is seen in psychogenic patients who have normal plasticity.

Keywords: associative plasticity; organic dystonia; psychogenic dystonia; paired associative stimulation; transcranial magnetic stimulation

Journal Article.  4312 words.  Illustrated.

Subjects: Neurology ; Neuroscience

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