Dataset Information

Finger muscle control in children with dystonia.

ABSTRACT: Childhood dystonia is a disorder that involves inappropriate muscle activation during attempts at voluntary movement. Few studies have investigated the muscle activity associated with dystonia in children, and none have done so in the hands.In this study, we measured surface electromyographic activity in four intrinsic hand muscles while participants attempted to perform an isometric tracking task using one of the muscles.Children with dystonia had greater tracking error with the task-related muscle and greater overflow to non-task muscles. Both tracking error and overflow correlated with the Barry-Albright Dystonia scale of the respective upper limb. Overflow also decreased when participants received visual feedback of non-task muscle activity.We conclude that two of the motor deficits in childhood dystonia--motor overflow and difficulties in actively controlling muscles--can be seen in the surface electromyographic activity of individual muscles during an isometric task. As expected from results in adults, overflow is an important feature of childhood dystonia. However, overflow may be at least partially dependent on an individual's level of awareness of their muscle activity. Most importantly, poor single-muscle tracking shows that children with dystonia have deficits of individual muscle control in addition to overflow or co-contraction. These results provide the first quantitative measures of the muscle activity associated with hand dystonia in children, and they suggest possible directions for control of dystonic symptoms.

SUBMITTER: Young SJ

PROVIDER: S-EPMC3119776 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Finger muscle control in children with dystonia.

Young Scott J SJ van Doornik Johan J Sanger Terence D TD

Movement disorders : official journal of the Movement Disorder Society 20110329 7

<h4>Background</h4>Childhood dystonia is a disorder that involves inappropriate muscle activation during attempts at voluntary movement. Few studies have investigated the muscle activity associated with dystonia in children, and none have done so in the hands.<h4>Methods</h4>In this study, we measured surface electromyographic activity in four intrinsic hand muscles while participants attempted to perform an isometric tracking task using one of the muscles.<h4>Results</h4>Children with dystonia ...[more]

PMID: 21449015

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Project description:ObjectiveFunctional dystonia (FD) is a disabling and diagnostically challenging functional movement disorder (FMD). We sought to identify historical predictors of FD vs. other primary dystonias (ODs) and develop a practical prediction algorithm to guide neurologists.Methods1475 consecutive new patient medical records were reviewed at an adult/pediatric tertiary-referral dystonia clinic from 2005 to 2017. Ninety-nine met criteria for clinically established FD (85 adults and 14 pediatric), paired with 99 age/dystonia distribution-matched OD. Univariate and multivariate regression analyses were performed to identify predictors of FD and disability. We formed a prediction algorithm, assessed using the area under the receiver operating curve (AUC).ResultsMultivariate logistic regression analysis investigating independent predictors of FD (P < 0.001) followed by development of a prediction algorithm showed that the most robust predictors included abrupt onset, spontaneous resolution/recurrence, pain, cognitive complaints, being on or pursuing disability, lifetime mood/anxiety disorder, comorbid functional somatic disorders, and having ≥3 medication allergies. The prediction algorithm had utility for both adult and pediatric FD, with excellent sensitivity/specificity (89%/92%) and an area under the curve (AUC) 0.95 (0.92-0.98). Greater disability (modified Rankin Scale) independently correlated with a number of functional examination features, unemployment/not attending school, number of medication allergies, and younger age of presentation. FD patients were high health-care utilizers and were more frequently prescribed opiates/opioids and benzodiazepines (P < 0.003).InterpretationThis case-control study provides an algorithm to guide clinicians in gauging their index of suspicion for a FD, with diagnostic confirmation subsequently informed by neurological examination. While this algorithm requires prospective validation, health-care utilization data underscore the importance and need for more research in FD.

Dataset Information

Finger muscle control in children with dystonia.

Publications

Finger muscle control in children with dystonia.

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