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Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

机译:音乐家对局灶性手肌张力障碍的有效行为治疗改变了体感皮层组织

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摘要

New perspectives in neurorehabilitation suggest that behavioral treatments of movement disorders may modify the functional organization of central somatosensory neural networks. On the basis of the assumption that use-dependent reorganization in these networks contributes to the fundamental abnormalities seen in focal dystonia, we treated 10 affected musicians and measured the concomitant somatosensory changes by using whole-head magnetoencephalography. We found that effective treatment, using the method of sensory motor retuning, leads to alterations in the functional organization of the somatosensory cortex. Specifically, before treatment, somatosensory relationships of the individual fingers differ between the affected and unaffected hands, whereas after treatment, finger representations contralateral to the dystonic side become more similar to the less-affected side. Further, somatosensory finger representations are ordered more according to homuncular principles after treatment. In addition, the observed physiologic changes correlated with behavioral data. These results confirm that plastic changes in parallel with emergent neurological dysfunction may be reversed by context-specific, intensive training-based remediation.
机译:神经康复的新观点表明,运动障碍的行为治疗可能会改变中枢躯体感觉神经网络的功能组织。基于这些网络中使用依赖的重组会导致局灶性肌张力障碍所见的基本异常这一假设,我们治疗了10位受影响的音乐家,并通过使用全脑磁脑图测量了伴随的体感变化。我们发现,使用感觉运动调节方法进行有效治疗会导致体感皮层功能组织的改变。具体而言,在治疗之前,患病手和未患病手之间各个手指的体感关系不同,而在治疗后,与张力障碍侧相对的手指代表与患病较少的一侧更相似。此外,在治疗之后,根据人的原理更多地对体感手指表示进行排序。另外,观察到的生理变化与行为数据相关。这些结果证实,与突发性神经功能障碍并行发生的可塑性改变可通过针对特定情境的,基于强化训练的补救措施来逆转。

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