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Clin Neurophysiol. 2018 Sep;129(9):1947-1954. doi: 10.1016/j.clinph.2018.05.028. Epub 2018 Jul 4.

Cervical dystonia: Normal auditory mismatch negativity and abnormal somatosensory mismatch negativity.

Author information

1
Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: andrewtw717@gmail.com.
2
Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.
3
Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
4
Department of Molecular and Clinical Sciences, St George's University of London, London.

Abstract

OBJECTIVE:

Previous electrophysiological and psychophysical tests have suggested that somatosensory integration is abnormal in dystonia. Here, we hypothesised that this abnormality could relate to a more general deficit in pre-attentive error/deviant detection in patients with dystonia. We therefore tested patients with dystonia and healthy subjects using a mismatch negativity paradigm (MMN), where evoked potentials generated in response to a standard repeated stimulus are subtracted from the responses to a rare "odd ball" stimulus.

METHODS:

We assessed MMN for somatosensory and auditory stimuli in patients with cervical dystonia and healthy age matched controls.

RESULTS:

We found a significant group ∗ oddball type interaction effect (F (1, 34) = 4.5, p = 0.04, ρI = 0.63). A follow up independent t-test for sMMN data, showed a smaller sMMN amplitude in dystonic patients compared to controls (mean difference control-dystonia: -1.0 µV ± 0.3, p < 0.00, t = -3.1). However the amplitude of aMMN did not differ between groups (mean difference control-dystonia: -0.2 µV ± 0.2, p = 0.24, t = -1.2). We found a positive correlation between somatosensory MMN and somatosensory temporal discrimination threshold.

CONCLUSION:

These results suggest that pre-attentive error/deviant detection, specifically in the somatosensory domain, is abnormal in dystonia. This could underlie some previously reported electrophysiological and psychophysical abnormalities of somatosensory integration in dystonia.

SIGNIFICANCE:

One could hypothesize a deficit in pre-conscious orientation towards potentially salient signals might lead to a more conservative threshold for decision-making in dystonia.

KEYWORDS:

Dystonia; Mismatch negativity (MMN); Somatosensory integration

PMID:
30015084
DOI:
10.1016/j.clinph.2018.05.028
[Indexed for MEDLINE]

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