Sensibilidad y dolor en distonías focales de la mano / Sensitivity and pain in focal dystonia of the hand

Introducción: Considerando las evidencias acumuladas actualmente es importante estudiar la fisiopatología tanto sensorial como motora de las distonías focales para comprenderlas y mejorar su tratamiento. Por ello, los objetivos del presente estudio son evaluar las aferencias somatosensoriales de los pacientes con distonía focal o segmentaria con afectación del miembro superior, comprobar si se corresponde con la mano de más uso, analizar la tolerancia al dolor y examinar la posible relación con la percepción del dolor en los pacientes con distonía segmentaria de la mano.MétodosSe contó con una muestra total de 24 participantes: 12 pacientes con distonía focal de la mano y 12 sujetos sin distonía. Todos ellos fueron evaluados con un algómetro electrónico (Somedic AB®, Farsta, Suecia), con los monofilamentos de Semmes-Weinstein y con la escala visual analógica.ResultadosLos datos hallados muestran, en la población estudiada, una mayor afectación en la sensibilidad superficial comparada con el grupo control, tanto en la mano dominante como en la no dominante, así como presencia de dolor (p > 0,001). Además, el grupo de distonía focal obtuvo una correlación negativa entre el dolor percibido y en el umbral de tolerancia de dolor a la presión (rho = −0,83; p < 0,001).ConclusionesLas personas con distonía segmentaria de la mano presentan una alteración en la sensibilidad y manifiestan mayor dolor percibido que las personas sin distonía. Se requieren más estudios con una muestra mayor que detecten las implicaciones clínicas y cotidianas, tanto del dolor objetivo como subjetivo. (AU)

Introduction: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia.MethodsWe recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain.ResultsAccording to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = −0.83; P < .001).ConclusionsPatients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain. (AU)

Sensitivity and pain in focal dystonia of the hand.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = -0.83; P < .001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.

Sensitivity and pain in focal dystonia of the hand. / Sensibilidad y dolor en distonías focales de la mano.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P>.001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho=-0.83; P<.001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.