Adaptation of feedforward movement control is abnormal in patients with cervical dystonia and tremor

Abstract

Objective: It is under debate whether the cerebellum plays a role in dystonia pathophysiology and in the expression of clinical phenotypes. We investigated a typical cerebellar function (anticipatory movement control) in patients with cervical dystonia (CD) with and without tremor.

Methods: Twenty patients with CD, with and without tremor, and 17 healthy controls were required to catch balls of different load: 15 trials with a light ball, 25 trials with a heavy ball (adaptation) and 15 trials with a light ball (post-adaptation). Arm movements were recorded using a motion capture system. We evaluated: (i) the anticipatory adjustment (just before the impact); (ii) the extent and rate of the adaptation (at the impact) and (iii) the aftereffect in the post-adaptation phase.

Results: The anticipatory adjustment was reduced during adaptation in CD patients with tremor respect to CD patients without tremor and controls. The extent and rate of adaptation and the aftereffect in the post-adaptation phase were smaller in CD with tremor than in controls and CD without tremor.

Conclusion: Patients with cervical dystonia and tremor display an abnormal predictive movement control.

Significance: Our findings point to a possible role of cerebellum in the expression of a clinical phenotype in dystonia.

Keywords: Anticipatory postural adjustments; Cerebellum; Cervical dystonia; Feedforward control; Learning; Motor adaptation; Tremor.