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Cortical neurophysiology of primary isolated dystonia and non‐dystonic adults: A meta‐analysis.

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Title: Cortical neurophysiology of primary isolated dystonia and non‐dystonic adults: A meta‐analysis.
Authors: McCambridge, Alana B. (AUTHOR), Bradnam, Lynley V. (AUTHOR)
Source: European Journal of Neuroscience. Feb2021, Vol. 53 Issue 4, p1300-1323. 24p. 2 Charts, 3 Graphs.
Subjects: Focal dystonia, Dystonia, Transcranial magnetic stimulation, Random effects model, Neurophysiology
Abstract: Transcranial magnetic stimulation (TMS) is a non‐invasive method to assess neurophysiology of the primary motor cortex in humans. Dystonia is a poorly understood neurological movement disorder, often presenting in an idiopathic, isolated form across different parts of the body. The neurophysiological profile of isolated dystonia compared to healthy adults remains unclear. We conducted a systematic review with meta‐analysis of neurophysiologic TMS measures in people with isolated dystonia to provide a synthesized understanding of cortical neurophysiology associated with isolated dystonia. We performed a systematic database search and data were extracted independently by the two authors. Separate meta‐analyses were performed for TMS measures of: motor threshold, corticomotor excitability, short interval intracortical inhibition, cortical silent period, intracortical facilitation and afferent‐induced inhibition. Standardized mean differences were calculated using a random effects model to determine overall effect sizes and confidence intervals. Heterogeneity was explored using dystonia type subgroup analysis. The search resulted in 78 studies meeting inclusion criteria, of these 57 studies reported data in participants with focal hand dystonia, cervical dystonia, blepharospasm or spasmodic dysphonia, and were included in at least one meta‐analysis. The cortical silent period, short‐interval intracortical inhibition and afferent‐induced inhibition was found to be reduced in isolated dystonia compared to controls. Reduced GABAergic‐mediated inhibition in the primary motor cortex in idiopathic isolated dystonia's suggest interventions targeted to aberrant cortical disinhibition could provide a novel treatment. Future meta‐analyses require neurophysiology studies to use homogeneous cohorts of isolated dystonia participants, publish raw data values, and record electromyographic responses from dystonic musculature where possible. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
  Group: Ti
  Data: Cortical neurophysiology of primary isolated dystonia and non‐dystonic adults: A meta‐analysis.
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  Data: <searchLink fieldCode="AR" term="%22McCambridge%2C+Alana+B%2E%22">McCambridge, Alana B.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bradnam%2C+Lynley+V%2E%22">Bradnam, Lynley V.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neuroscience%22">European Journal of Neuroscience</searchLink>. Feb2021, Vol. 53 Issue 4, p1300-1323. 24p. 2 Charts, 3 Graphs.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Focal+dystonia%22">Focal dystonia</searchLink><br /><searchLink fieldCode="DE" term="%22Dystonia%22">Dystonia</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+magnetic+stimulation%22">Transcranial magnetic stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Random+effects+model%22">Random effects model</searchLink><br /><searchLink fieldCode="DE" term="%22Neurophysiology%22">Neurophysiology</searchLink>
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  Label: Abstract
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  Data: Transcranial magnetic stimulation (TMS) is a non‐invasive method to assess neurophysiology of the primary motor cortex in humans. Dystonia is a poorly understood neurological movement disorder, often presenting in an idiopathic, isolated form across different parts of the body. The neurophysiological profile of isolated dystonia compared to healthy adults remains unclear. We conducted a systematic review with meta‐analysis of neurophysiologic TMS measures in people with isolated dystonia to provide a synthesized understanding of cortical neurophysiology associated with isolated dystonia. We performed a systematic database search and data were extracted independently by the two authors. Separate meta‐analyses were performed for TMS measures of: motor threshold, corticomotor excitability, short interval intracortical inhibition, cortical silent period, intracortical facilitation and afferent‐induced inhibition. Standardized mean differences were calculated using a random effects model to determine overall effect sizes and confidence intervals. Heterogeneity was explored using dystonia type subgroup analysis. The search resulted in 78 studies meeting inclusion criteria, of these 57 studies reported data in participants with focal hand dystonia, cervical dystonia, blepharospasm or spasmodic dysphonia, and were included in at least one meta‐analysis. The cortical silent period, short‐interval intracortical inhibition and afferent‐induced inhibition was found to be reduced in isolated dystonia compared to controls. Reduced GABAergic‐mediated inhibition in the primary motor cortex in idiopathic isolated dystonia's suggest interventions targeted to aberrant cortical disinhibition could provide a novel treatment. Future meta‐analyses require neurophysiology studies to use homogeneous cohorts of isolated dystonia participants, publish raw data values, and record electromyographic responses from dystonic musculature where possible. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ejn.14987
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        Text: English
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      – SubjectFull: Focal dystonia
        Type: general
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      – SubjectFull: Transcranial magnetic stimulation
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      – SubjectFull: Random effects model
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      – SubjectFull: Neurophysiology
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      – TitleFull: Cortical neurophysiology of primary isolated dystonia and non‐dystonic adults: A meta‐analysis.
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              Text: Feb2021
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              Y: 2021
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