Objective. Dystonia is a disabling movement disorder that manifests with sustained co-contraction of agonist and antagonist muscles, giving rise to abnormal twisted postures and overflow of muscle activity. Abnormal neurophysiologic parameters of the somatosensory and motor cortex have been demonstrated, although it is unclear how these changes lead to the predominant motor manifestations. In normal voluntary movement, communication between sensory and motor cortices is important and these interactions may be dysfunctional in dystonia. Coherence is a powerful method used to assess brain communication and has been instrumental in demonstrating the interregional interactions involved in normal movement. Inappropriate connectivity in terms of the duration of communication or the extent of spread over sensorimotor areas may give rise to the involuntary overflow of movements that characterize dystonia. We propose to examine changes in coherence associated with disorganized movements to yield insight as to the brain networks involved in the development and expression of the disease.

Study population. Patients with focal hand dystonia and normal volunteers will take part in the study.

Design. In this study, EEG/MEG coherence analysis will be used to investigate corticocortical interactions during voluntary hand movements in focal hand dystonia patients and normal subjects. Power spectral changes in the beta and alpha frequency range over the hand sensorimotor cortex will be studied using a 28-channel EEG montage while subjects perform various tasks involving the hand. The interregional coherence between sensory and motor, premotor and motor, and interhemispheric cortices will be assessed for changes between study populations.

Outcome Measures. Comparison of interregional coherence changes will be performed between dystonia patients and normal volunteers as well as between affected and unaffected sides. Furthermore, coherence changes will be compared between rest and during task performance.

Further Study Details: 

Expected Total Enrollment:  30

Objective. Dystonia is a disabling movement disorder that manifests with sustained co-contraction of agonist and antagonist muscles, giving rise to abnormal twisted postures and overflow of muscle activity. Abnormal neurophysiologic parameters of the somatosensory and motor cortex have been demonstrated, although it is unclear how these changes lead to the predominant motor manifestations. In normal voluntary movement, communication between sensory and motor cortices is important and these interactions may be dysfunctional in dystonia. Coherence is a powerful method used to assess brain communication and has been instrumental in demonstrating the interregional interactions involved in normal movement. Inappropriate connectivity in terms of the duration of communication or the extent of spread over sensorimotor areas may give rise to the involuntary overflow of movements that characterize dystonia. We propose to examine changes in coherence associated with disorganized movements to yield insight as to the brain networks involved in the development and expression of the disease.

Study population. Patients with focal hand dystonia and normal volunteers will take part in the study.

Design. In this study, EEG/MEG coherence analysis will be used to investigate corticocortical interactions during voluntary hand movements in focal hand dystonia patients and normal subjects. Power spectral changes in the beta and alpha frequency range over the hand sensorimotor cortex will be studied using a 28-channel EEG montage while subjects perform various tasks involving the hand. The interregional coherence between sensory and motor, premotor and motor, and interhemispheric cortices will be assessed for changes between study populations.

Outcome Measures. Comparison of interregional coherence changes will be performed between dystonia patients and normal volunteers as well as between affected and unaffected sides. Furthermore, coherence changes will be compared between rest and during task performance.

Genders Eligible for Study:  Both

Criteria

INCLUSION CRITERIA:

-Normal subjects: Healthy volunteers who consent to participate in the study

-Patients diagnosed with focal hand dystonia: unilateral focal hand dystonia who consent to participate in the study

EXCLUSION CRITERIA:

-Normal subjects: abnormal neurologic exam or history of previous neurological disease that might affect the functioning of the hands

-Dystonia patients: presence of a second neurologic disease or condition that might affect the functioning of the hands; abnormal neurologic findings on exam not related to the focal hand dystonia that might affect the functioning of the hands; the use of Botulinum toxin within 3 months prior to study participation

-For MRI studies, patients with metallic implants will be excluded to avoid potential risks from this procedure

-For MRI studies, women who are pregnant are excluded from this part of the protocol. All women of childbearing potential will have a pregnancy test performed prior to MRI studies, which must be negative, before proceeding.

Please refer to this study by ClinicalTrials.gov identifier  NCT00137384

Maryland
      National Institute of Neurological Disorders and Stroke (NINDS), 9000 Rockville Pike,  Bethesda,  Maryland,  20892,  United States; Recruiting

Study ID Numbers:  050228; 05-N-0228
Last Updated:  August 29, 2005
Record first received:  August 26, 2005
ClinicalTrials.gov Identifier:  NCT00137384
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-08-30