Psychophysical and Neurophysiological Correlates of Practice- Induced Cortical Changes in Focal Hand Dystonia as a Model of Brain Plasticity in Humans

Candia, Victor

Psychophysical and Neurophysiological Correlates of Practice- Induced Cortical Changes in Focal Hand Dystonia as a Model of Brain Plasticity in Humans

Files

CANDIA_DISS.pdf(2.66 MB)

Date

2004

Authors

Candia, Victor

Title in another language

Psychophysische und neurophysiologische Korrelate übungsinduzierter kortikaler Veränderungen in der Fokalen Handdystonie als Modell von Gehirnplastizität beim Menschen

Publication type

Dissertation

Abstract

Cortical plasticity appears to be involved in the etiology of focal hand dystonia, a very often task-specific sensorimotor disorder. The simultaneous two-point finger discrimination of some affected patients was evaluated. Dystonic musicians showed loss of perceptual symmetry between dystonic and non-affected hands. These changes were specific to their dystonic zones. Homologous asymmetries were not observed in writer s cramp, another form of focal hand dystonia. Using Magnetoencephalography (MEG), a smaller distance between the representations of the digits in the somatosensory cortex of the affected hand of dystonic musicians compared to the hands of non-affected individuals was demonstrated. A behavioral intervention produced long-term reduction of symptoms in some affected musicians, and their subjective ratings were highly correlated with objective data depicting changes in smoothness of finger movements. Pre- to post-treatment changes in somatosensory cortex were measured using whole head MEG. It was found that effective treatment with Sensory Motor Retuning (SMR) leads to alterations in functional organization of the somatosensory cortex. After treatment, somatosensory relationships of the individual fingers of the affected hand were similar to the non-affected side, and more ordered according to homuncular principles. The observed physiologic changes correlated with behavioral data obtained with a displacement dexterity device. These results confirmed that sensory anomalies are associated with focal hand dystonia and extend far beyond of the affected task. Cortical changes in parallel with emergent neurological dysfunction may be reversed by context specific intensive training protocols. It was demonstrated that cortical plasticity in response to behavioral interventions can be successfully assessed using non-invasive neuroimaging techniques. Some possible mechanisms of cortical plasticity mediating all of the observed changes were discussed.

Summary in another language

In der Ätiologie der fokalen Dystonie der Hand, eine meistens aufgabenspezifische sensomotorische Störung, scheint die kortikale Plastizität involviert zu sein. Die simultane Zwei-Punkte-Schwelle wurde bei einigen betroffenen Patienten untersucht. Dystone Musiker zeigten Wahrnehmungsasymmetrien zwischen der dystonen und ihrer nicht dystonen Hand. Die beobachteten Veränderungen waren spezifisch für ein im Voraus definiertes dystones Areal. Homologe Asymmetrien konnten bei einer Gruppe mit Schreibkrampf, einer anderen Form der fokalen Dystonie, nicht beobachtet werden. Kleinere Distanzen der Fingerrepräsentationen der betroffenen Hand im somatosensorischen Kortex einiger betroffener Musiker, konnte mit Hilfe der Magnetenzephalographie (MEG) festgestellt werden. Eine Verhaltensintervention konnte die Symptome einiger Musiker langfristig bessern. Die subjektiven Urteile der Betroffenen korrelierten hoch mit objektiv gemessenen Bewegungsprofile der Finger. Die Repräsentation der Finger im somatosensorischen Kortex vor und nach Therapie wurde wiederum mittels MEG gemessen. Dabei konnte gezeigt werden, dass Sensory Motor Retuning, eine effektive Verhaltensintervention für die fokale Dystonie der Hand, zu Veränderungen der funktionellen Organisation in den kortikalen Arealen führte. Nach der Therapie ähnelten die somatosensorischen Beziehungen zwischen den einzelnen Fingern der betroffenen Hand denen der Fingerbeziehungen in der nicht betroffenen Hand. Darüber hinaus war die Fingerorganisation einer homunkulären Organisation ähnlicher. Die beobachteten physiologischen Veränderungen korrelierten mit Verhaltensdaten, die mit einem Bewegungsaufnahmegerät gewonnen wurden. Die Ergebnisse zeigten, dass die fokale Dystonie der Hand mit sensorischen Anomalien in Beziehung steht. Diese Anomalien können sich auf Bereiche ausdehnen, die mit der betroffenen Tätigkeit nicht in Beziehung stehen. Kortikale Veränderungen und die mit ihnen einhergehenden neurologischen Dysfunktionen könnten unter Zuhilfenahme kontextspezifischer und intensiver Trainingsprotokolle verändert bzw. gebessert werden. Es wurde gezeigt, dass die durch Verhaltensinterventionen veränderte kortikale Organisationen mit Hilfe nicht-invasiver bildgebender Verfahren erfolgreich untersucht werden kann. Einige der für die fokale Dystonie der Hand mutmaßlichen Mechanismen kortikaler Plastizität wurden diskutiert.

Subject (DDC)

150 Psychology

Keywords

Brain Plasticity,Magnetencephalography,Psychophysics,Clinical Neuropsychology

Cite This

ISO 690

CANDIA, Victor, 2004. Psychophysical and Neurophysiological Correlates of Practice- Induced Cortical Changes in Focal Hand Dystonia as a Model of Brain Plasticity in Humans [Dissertation]. Konstanz: University of Konstanz

BibTex

@phdthesis{Candia2004Psych-11356,
  year={2004},
  title={Psychophysical and Neurophysiological Correlates of Practice- Induced Cortical Changes in Focal Hand Dystonia as a Model of Brain Plasticity in Humans},
  author={Candia, Victor},
  address={Konstanz},
  school={Universität Konstanz}
}

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Examination date of dissertation

March 10, 2004