Differences in somatosensory hand organization in a healthy flutist and a flutist with focal hand dystonia: a case report.
J Hand Ther
; 13(4): 302-9, 2000.
Article
em En
| MEDLINE
| ID: mdl-11129255
ABSTRACT
Focal hand dystonia is a disabling, involuntary disorder of movement that can disrupt a successful musician's career. This problem is difficult to treat, to some extent because we do not fully understand its origin. Somatosensory degradation has been proposed as one etiology. The purpose of this case study was to compare the differences in the somatosensory hand representation of two female flutists, one with focal dystonia of the left hand (digits 4 and 5) and one a healthy subject (the control). Noninvasive magnetic source imaging was performed on both subjects. The somatosensory evoked potentials of controlled taps to the fingers were measured with a 37-channel biomagnetometer and reported in terms of the neuronal organization, latency, amplitude, density, location, and spread of the digits on each axis (x, y, and z). The somatosensory representation of the involved hand of the flutist with dystonia differed from that of the healthy flutist. The magnetic fields evoked from the primary somatosensory cortex had a disorganized pattern of firing, with a short latency and excessive amplitude in the involved digits of the affected hand, as well as inconsistency (decreased density). In addition, the patterns of firing were different in terms of the location of the digits on the x, y, and z axes and sequential organization of the digits. This study confirms that somatosensory evoked magnetic fields can be used to describe the representation of the hand on the somatosensory cortex in area 3b. Degradation in the hand representation of the flutist with focal hand dystonia was evident, compared with the hand representation of the healthy flutist. It is not clear whether the sensory degradation was the cause or the consequence of the dystonia. The questions are whether re-differentiation of the representation could be achieved with aggressive sensory retraining and whether improvement in structure would be correlated with improvement in function.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Córtex Somatossensorial
/
Transtornos Traumáticos Cumulativos
/
Distúrbios Distônicos
/
Música
/
Doenças Profissionais
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
J Hand Ther
Assunto da revista:
REABILITACAO
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Estados Unidos