Movement disorders are neurological illnesses that impair the ability of the body to produce and govern movement. While precise diagnosis is often challenging, our professionals at SSM Health Neurosciences will collaborate with you to do a full evaluation to establish the cause of your symptoms.
Recent discoveries made by Charité – Universitätsmedizin Berlin researchers may be crucial in improving the treatment of dystonia, a neurological movement disease. Their findings, published in PNAS, reveal that very specific networks in the brain must be engaged in order to alleviate the symptoms seen in various kinds of dystonia.
The phrase “movement disorders” refers to a collection of nerve system (neurological) illnesses that involve abnormally increased motions, which can be voluntary or involuntary. Movement disorders can also result in limited or delayed movement.
Dystonia is an uncommon neurological condition characterized by uncontrollable, twisting, and distorted movements and postures. People suffering from dystonia may find it difficult to conduct daily activities such as drinking, walking, and speaking. Around 160,000 people in Germany suffer with dystonia. The disorder is split into two types: generalized dystonia, which affects the entire body, and localized dystonia, which affects only certain areas of the body.
Our findings demonstrate distinct variances in optimum stimulation sites that correspond to the somatotopic anatomy of the inner pallidum. This suggests that neuronal areas in the brain correspond to sections of the body.
Dr. Andreas Horn
Cervical dystonia, which affects the neck, is included in the latter category. The fundamental causes of the disorder are unknown, but doctors believe that symptoms are caused by incorrect interactions between specific parts of the brain, which result in abnormal signal transmission. Genetic abnormalities may also play a role depending on the type of dystonia implicated.
A neurosurgical operation involving the insertion of electrodes into particular parts of the brain is one therapy option offered to people with dystonia. When the electrodes are implanted, they transmit weak electrical signals that aid in the restoration of normal brain function. The operation, known as deep brain stimulation, involves the insertion of a pacemaker-like device and is frequently the only treatment capable of delivering symptom alleviation.
“Until now, it was unclear how precisely this stimulation had to be adapted to the symptoms seen in different types of dystonia,” explains study lead Prof. Dr. Andrea Kühn, who is Head of the Department of Neurology and Experimental Neurology’s Movement Disorders and Neuromodulation Section and Spokesperson of the ‘ReTune’ Transregional Collaborative Research Center (SFB/Transregio TRR 295), which helped to support the current study.
Prof. Kühn’s team analyzed a total of 80 individuals who had had therapy for either generalized or cervical dystonia at one of five different institutions in Germany and Austria. After studying the precise placements of the electrodes, the researchers were able to construct computer models that showed which brain networks were activated in each of the patients studied. The researchers were able to determine which of the discovered networks were critical to treatment effectiveness by mapping data on symptom improvements to their network models.
One important discovery was that the best target for stimulation varies on the type of dystonia being treated. This suggests that excellent treatment effects were linked to specific connections between the thalamus and the pallidum (the largest structure in the diencephalon, or ‘interbrain’ (a pale-colored structure at the core of the basal ganglia). The basal ganglia are deep-seated brain regions that help control movement.
The decisive factor in patients with cervical dystonia was electrical stimulation of a specific neural network, which also stimulated the head and neck portion of the primary motor cortex. As the brain’s motor command center, this area is in charge of movement planning and execution, as well as movement memory storage. In contrast, positive effects were evoked in patients with generalized dystonia by stimulating a separate network that projected to the entire primary motor cortex.
“Our findings demonstrate distinct variances in optimum stimulation sites that correspond to the somatotopic anatomy of the inner pallidum. This suggests that neuronal areas in the brain correspond to sections of the body,” explains the study’s first author, Dr. Andreas Horn of the Department of Neurology and Experimental Neurology. “Because of the scarcity of alternative therapeutic options outside deep brain stimulation, our findings represent an essential contribution to enhancing dystonia treatment,” he says. We will be able to treat certain varieties of the condition more specifically in the future.”
