Protocol Number: 06-N-0126

Title:

Neurophysiology of Task-Specificity of Focal Hand Dystonia

Number:

06-N-0126

Summary:

This study will examine how the brain coordinates movement in patients with focal hand dystonia. Patients with dystonia have muscle spasms that cause uncontrolled twisting and repetitive movement or abnormal postures. In focal dystonia, just one part of the body, such as the hand, neck or face, is involved. This study will use transcranial magnetic stimulation (TMS, see below) to study how the brain plans movement.

Healthy volunteers and patients with focal hand dystonia 18 years of age and older may be eligible for this study. Healthy subjects may participate in one, two or three of the experiments described below. Patients with dystonia may participate in experiments one and three.

Before each experiment, each subject is asked about his/her medical and neurologic history, complete questionnaires and will undergo a brief physical examination.

Experiment 1

-Surface EMG: Small electrodes are taped to the skin over the arm to measure the electrical activity of muscles.

-TMS: A wire coil is held on the subject's scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that stimulates the brain. During the stimulation, the subject may be asked to tense certain muscles slightly or perform other simple actions. The stimulation may cause a twitch in muscles of the face, arm, or leg, and the subject may hear a click and feel a pulling sensation on the skin under the coil.

Experiment 2 (Two visits.)

-Visit 1: Magnetic resonance imaging (MRI): This test uses a magnetic field and radio waves to obtain images of body tissues and organs. The patient lies on a table that is moved into the scanner (a metal cylinder), wearing earplugs to muffle loud knocking and thumping sounds that occur during the scanning process. The procedure lasts about 90 minutes, during which time the patient will be asked to lie still for up to 30 minutes at a time.

-Visit 2: Surface EMG and TMS

Experiment 3

-Surface EMG and TMS - During the TMS, subjects are asked to respond to shapes on a computer screen by pushing a button or pressing a foot petal.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Participants currently recruited/enrolled

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA:

Patients:

- Age over 18 years

- Presence of FHD, specifically writer's cramp

Healthy volunteers:

- Age over 18 years

- Absence of dystonia or other neurologic condition

EXCLUSION CRITERIA:

Patients and Healthy volunteers:

- Concurrent medical, surgical, neurologic or psychiatric condition

- Taking medications which include antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinson, hypnotics, stimulants, and/or antihistamines

- Received botulinum toxin injection within 3 months of starting the protocol

- Presence of pacemaker, implanted medical pump, metal plate or metal object in skull or eye

- History of seizure disorder

- For healthy volunteers undergoing MRI, subjects with implanted devices such as pacemakers, medication pumps or defibrillators, metal in the cranium except mouth, intracardiac lines, history of shrapnel injury or any other condition/device that may be contraindicated or prevent the acquisition of MRI and/or current pregnancy

- A serious medical illness which prevents them from lying flat for up to 60 minutes

- Claustrophobia (a fear of tight spaces), which prevents them from lying still in a tight or small space for up to 60 minutes

Special Instructions:

Currently Not Provided

Keywords:

Focal Hand Dystonia

Motor Planning

Transcranial Magnetic Stimulation (TMS)

MRI (Magnetic Resonance Imaging)

Recruitment Keyword(s):

Focal Hand Dystonia

FHD

Writer's Cramp

Healthy Volunteer

HV

Condition(s):

Focal Dystonia

Investigational Drug(s):

None

Investigational Device(s):

None

Intervention(s):

None

Supporting Site:

National Institute of Neurological Disorders and Stroke

Contact(s):

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):

Hallett M. Dystonia: abnormal movements result from loss of inhibition. Adv Neurol. 2004;94:1-9. Review. No abstract available.

Bressman SB. Dystonia genotypes, phenotypes, and classification. Adv Neurol. 2004;94:101-7. Review. No abstract available.

Chen R, Hallett M. Focal dystonia and repetitive motion disorders. Clin Orthop Relat Res. 1998 Jun;(351):102-6. Review.

• Questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.
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