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January 11, 2000

Shortened cortical silent period in facial muscles of patients with cranial dystonia

January 11, 2000 issue
54 (1) 130

Abstract

Objective: To study the cortical silent period (SP) in the orbicularis oculi and perioral muscles in 23 patients with cranial dystonia and 10 age-matched control subjects.
Methods: High-intensity magnetic stimuli were delivered with a round coil centered at the vertex during a maximal muscle contraction. Electromyographic (EMG) responses were recorded from surface electrodes placed over the orbicularis oculi and perioral muscles.
Results: SPs elicited in upper and lower facial muscles had a similar duration. Facial muscle SPs were significantly shorter in patients than in control subjects. Patients with blepharospasm plus oromandibular dystonia had shorter SPs than patients with blepharospasm alone. Although patients’ recordings showed reduced voluntary and evoked EMG activity, neither activities correlated with the duration of the SP.
Conclusions: Silent period (SP) shortening depends neither on the level of electromyographic activity nor on segmentary mechanisms. The shortened SP in facial muscles reflects hypoexcitability of cortical inhibitory neurons in cranial dystonia.

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References

1.
Berardelli A, Rothwell JC, Day BL, Marsden CD. Pathophysiology of blepharospasm and oromandibular dystonia. Brain 1985;108:593–608.
2.
Tolosa E, Montserrat L, Bayse A. Blink reflex studies in focal dystonias: enhanced excitability of brainstem interneurons in cranial dystonia and spasmodic torticollis. Mov Disord 1988;3:61–69.
3.
Cruccu G, Pauletti G, Agostino R, Berardelli A, Manfredi M. Masseter inhibitory reflex in movement disorders, Huntington’s chorea, Parkinson’s disease, dystonia, and unilateral masticatory spasm. Electroencephalogr Clin Neurophysiol 1991;81:24–30.
4.
Aramideh M, Eekhof JLA, Bour LJ, Koelman JHTM, Speelman JD, Ongerboer de Visser BW. Electromyography and recovery of the blink reflex in involuntary eyelid closure: a comparative study. J Neurol Neurosurg Psychiatry 1995;58:692–698.
5.
Eekhof JL, Aramideh M, Bour LJ, Hilgevoord AA, Speelman HD, Ongerboer de Visser BW. Blink reflex recovery curves in blepharospasm, torticollis, and hemifacial spasm. Muscle Nerve 1996;19:10–15.
6.
Berardelli A, Rothwell JC, Hallett M, Thompson PD, Manfredi M, Marsden CD. The pathophysiology of primary dystonia. Brain 1998;121:1195–1212.
7.
Fuhr P, Agostino R, Hallett M. Spinal motor neuron excitability during the silent period after cortical stimulation. Electroencephalogr Clin Neurophysiol 1991;81:257–262.
8.
Inghilleri M, Berardelli A, Cruccu G, Manfredi M. Silent period evoked by transcranial stimulation of the human cortex and cervicomedullary junction. J Physiol (Lond) 1993;466:521–534.
9.
Roick H, von Giesen HJ, Benecke R. On the origin of the postexcitatory inhibition seen after transcranial magnetic brain stimulation in awake human subjects. Exp Brain Res 1993;94:489–498.
10.
Uncini A, Treviso M, Di Muzio A, Simone P, Pulmann S. Physiological basis of voluntary activity inhibition induced by transcranial magnetic stimulation. Electroencephalogr Clin Neurophysiol 1993;89:211–220.
11.
Leis AA, Kofler M, Stokic DS, Grubweiser GJ, Delapasse JS. Effect of the inhibitory phenomenon following magnetic stimulation of the cortex on brainstem motor neuron excitability and on the cortical control of brainstem reflexes. Muscle Nerve 1993;16:1351–1358.
12.
Cruccu G, Inghilleri M, Berardelli A, Romaniello A, Manfredi M. Cortical mechanisms mediating the inhibitory period after magnetic stimulation of the facial motor area. Muscle Nerve 1997;20:418–424.
13.
Benecke R, Meyer BU, Schönle P, Conrad B. Transcranial magnetic stimulation of the human brain: responses in muscles supplied by cranial nerves. Exp Brain Res 1988;71:623–632.
14.
Cruccu G, Inghilleri M, Berardelli A, Pauletti G, Manfredi M. Cortico-facial and cortico-trigeminal projections. A comparison by magnetic brain stimulation in man. Electroencephalogr Clin Neurophysiol 1990; (suppl 41):140–144.
15.
Meyer BU, Werhahn K, Rothwell JC, Roericht S, Fauth C. Functional organisation of corticonuclear pathways to motoneurones of lower facial muscles in man. Exp Brain Res 1994;101:465–472.
16.
Cruccu G, Berardelli A, Inghilleri M, Manfredi M. Corticobulbar projections to upper and lower facial motoneurons. A study by magnetic transcranial stimulation in man. Neurosci Lett 1990;117:68–73.
17.
Rösler KM, Hess CW, Schmid UD. Investigation of facial motor pathways by electrical and magnetic stimulation: sites and mechanisms of excitation. J Neurol Neurosurg Psychiatry 1989;52:1149–1156.
18.
Berardelli A, Priori A, Inghilleri M, Cruccu G, Mercuri B, Manfredi M. Corticobulbar and corticospinal projections to neck muscle motoneurons in man. Exp Brain Res 1991;87:402–406.
19.
Rothwell JC, Thompson PD, Day BL, Boyd S, Marsden CD. Stimulation of the human motor cortex through the scalp. Exp Physiol 1991;76:159–200.
20.
Mavroudakis N, Caroyer JM, Brunko E, Zegers de Beyl D. Abnormal motor evoked responses to transcranial magnetic stimulation in focal dystonia. Neurology 1995;45:1671–1677.
21.
Ikoma K, Samii A, Mercuri B, Wassermann EM, Hallett M. Abnormal cortical motor excitability in dystonia. Neurology 1996;46:1371–1376.
22.
Rona S, Berardelli A, Vacca L, Inghilleri M, Manfredi M. Alterations of motor cortical inhibition in patients with dystonia. Mov Disord 1998;13:118–124.
23.
Filipovic SR, Ljubisavljevic M, Svetel M, Milanovic S, Kacar A, Kostic VS. Impairment of cortical inhibition in writer’s cramp as revealed by changes in electromyographic silent period after transcranial magnetic stimulation. Neurosci Lett 1997;222:167–170.
24.
Odergren T, Rimpilainen I, Borg J. Sternocleidomastoid muscle responses to transcranial magnetic stimulation in patients with cervical dystonia. Electroencephalogr Clin Neurophysiol 1997;105:44–52.
25.
Cocito D, Cassano D, De Mattei M. Motor evoked potentials in orbicularis oris muscle: no evidence of ipsilateral corticonuclear projections. Muscle Nerve 1993;16:1268–1270.
26.
Odergren T, Tollback A, Borg J. Electromyographic single motor unit potentials after repeated botulinum toxin treatments in cervical dystonia. Electroencephalogr Clin Neurophysiol 1994;93:325–329.
27.
Triggs WJ, Macdonell RA, Cros D, Chiappa KH, Shahani BT, Day BJ. Motor inhibition and excitation are independent effects of magnetic cortical stimulation. Ann Neurol 1992;32:245–351.
28.
Crosby EC, Humphrey T, Lauer EW. Correlative anatomy of the nervous system. New York:Macmillan, 1962:161–165.
29.
Folkins JW, Larson CR. In search of a tonic vibration reflex in the human lip. Brain Res 1978;151:409–412.
30.
Lorente de No R. Vestibulo-ocular reflex arc. Arch Neurol Psychiatry 1933;30:245–291.
31.
Poppele RE. The muscle spindle. In: Dyck PJ, Thomas PK, eds. Peripheral neuropathy. 3rd ed., vol. 1. Philadelphia: WB Saunders, 1993:21–140.
32.
von Giesen HJ, Roick H, Benecke R. Inhibitory actions of motor cortex following unilateral brain lesions as studied by magnetic brain stimulation. Exp Brain Res 1994;99:84–96.
33.
Schnitzler A, Benecke R. The silent period after transcranial magnetic stimulation is of exclusive cortical origin: evidence from isolated cortical ischemic lesions in man. Neurosci Lett 1994;180:41–45.
34.
Ceballos–Baumann AO, Passingham RE, Warner T, Playford ED, Marsden CD, Brooks DJ. Overactive prefrontal and underactive motor cortical areas in idiopathic dystonia. Ann Neurol 1995;37:363–372.
35.
Playford ED, Passingham RE, Marsden CD, Brooks DJ. Increased activation of frontal areas during arm movement in idiopathic torsion dystonia. Mov Disord 1998;13:309–318.
36.
Tempel LW, Perlmutter JS. Abnormal cortical responses in patients with writer’s cramp. Neurology 1993;43:2252–2257.
37.
Feiwell RJ, Black KJ, McGee–Minnich LA, Snyder AZ, MacLeod AM, Perlmutter JS. Diminished regional cerebral blood flow response to vibration in patients with blepharospasm. Neurology 1999;52:291–297.
38.
Wichmann T, DeLong M. Functional and pathophysiological models of basal ganglia. Curr Opin Neurobiol 1996;6:751–758.
39.
Eidelberg D, Moeller JR, Ishikawa T, et al. The metabolic topography of idiopathic torsion dystonia. Brain 1995;118:1473–1484.
40.
Dum RP, Strick PL. Premotor areas: nodal points for parallel efferent systems involved in the central control of movements. In: Humphrey DR, Freund HJ, eds. Motor control: concepts and issues. New York:Wiley, 1991:383—397.
41.
Nakashima K, Rothwell JC, Thompson PD, et al. The blink reflex in patients with idiopathic torsion dystonia. Arch Neurol 1990;47:413—416.
42.
Pauletti G, Berardelli A, Cruccu G, Agostino R, Manfredi M. Blink reflex and the masseter inhibitory reflex in patients with dystonia. Mov Disord 1993;8:495—500.

Information & Authors

Information

Published In

Neurology®
Volume 54Number 1January 11, 2000
Pages: 130
PubMed: 10636138

Publication History

Received: May 3, 1999
Accepted: July 29, 1999
Published online: January 11, 2000
Published in print: January 11, 2000

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Authors

Affiliations & Disclosures

A. Currà, MD
From the Dipartimento di Scienze Neurologiche (Drs. RomanielloBerardelli, Cruccu, and Manfredi), Università di Roma “La Sapienza”; and the Istituto Neurologico Mediterraneo Neuromed (Drs. Currà, Berardelli, and Manfredi), Pozzilli, Isernia, Italy.
A. Romaniello, MD
From the Dipartimento di Scienze Neurologiche (Drs. RomanielloBerardelli, Cruccu, and Manfredi), Università di Roma “La Sapienza”; and the Istituto Neurologico Mediterraneo Neuromed (Drs. Currà, Berardelli, and Manfredi), Pozzilli, Isernia, Italy.
A. Berardelli, MD
From the Dipartimento di Scienze Neurologiche (Drs. RomanielloBerardelli, Cruccu, and Manfredi), Università di Roma “La Sapienza”; and the Istituto Neurologico Mediterraneo Neuromed (Drs. Currà, Berardelli, and Manfredi), Pozzilli, Isernia, Italy.
G. Cruccu, MD
From the Dipartimento di Scienze Neurologiche (Drs. RomanielloBerardelli, Cruccu, and Manfredi), Università di Roma “La Sapienza”; and the Istituto Neurologico Mediterraneo Neuromed (Drs. Currà, Berardelli, and Manfredi), Pozzilli, Isernia, Italy.
M. Manfredi, MD
From the Dipartimento di Scienze Neurologiche (Drs. RomanielloBerardelli, Cruccu, and Manfredi), Università di Roma “La Sapienza”; and the Istituto Neurologico Mediterraneo Neuromed (Drs. Currà, Berardelli, and Manfredi), Pozzilli, Isernia, Italy.

Notes

Address correspondence and reprint requests to Dr. Alfredo Berardelli, Dipartimento di Scienze Neurologiche (Box no. 41), Viale dell’Università 30, I-00185 Rome, Italy.

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