Protocol Number: 06-N-0242

Title:

The Effect of Surround Inhibition During Phasic Compared to Tonic Voluntary Finger Movement in Focal Hand Dystonia

Number:

06-N-0242

Summary:

This study will examine and compare brain activity in people with focal hand dystonia (FHD) and healthy volunteers to obtain further knowledge about the underlying cause of FHD. Patients with dystonia have muscle spasms that cause abnormal postures while trying to perform a movement; FHD affects the hands and fine finger movements. During fine finger movement, the brain controls muscles in a process called surround inhibition. This process may be impaired in people with hand dystonia, leading to uncontrolled overactivity in muscles and impairing motor function.

Healthy volunteers and patients with FHD over 18 years of age may be eligible for this study. Candidates are screened with a physical and neurological examination.

In a series of three experiments conducted during a single clinic visit, participants undergo transcranial magnetic stimulation (TMS) while performing a finger movement. A wire coil is placed on the subject's scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that travels through the scalp and skull and causes small electrical currents in the outer part of the brain. The stimulation may cause muscle, hand or arm twitching, or may affect movement or reflexes. During the stimulation, the subject is asked to contract one finger.

In addition to TMS, subjects have surface electromyography. For this test, they sit in a chair with their hands placed on a pillow on their lap. The electrical activity of three muscles in the right hand is recorded by electrodes (small metal disks) taped to the skin over the muscles.

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:

18 years old or older

Presence of FHD, for Experiment 5, 6, 7 and 8 the affected limb has to be the right and dominant side

HEALTHY VOLUNTEERS:

18 years old or older

Right handedness

Absence of dystonia or other neurological disorder with any effect on the motor or sensory systems

EXCLUSION CRITERIA:

PATIENTS AND HEALTHY VOLUNTEERS:

Concurrent significant medical, surgical, neurological or psychiatric condition

Taking the following medications: antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinson, hypnotics, stimulants, and/or antihistamines

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

For TMS: Presence of pacemaker, implanted medical pump, metal plate or metal object in skull or eye

History of seizure disorder

Known history of hearing loss

For MRI: Presence of pacemakers or other implanted electrical devices, brain stimulators, dental implants, aneurysm clips, metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pumps, or shrapnel fragments. Welders and metal workers are also at risk for injury because of possible small metal fragments in the eye of which they may be unaware.

Pregnancy.

Special Instructions:

Currently Not Provided

Keywords:

Transcranial Magnetic Stimulation (TMS)

Writer's Cramp

Electromyogram

Recruitment Keyword(s):

Focal Hand Dystonia

FHD

Writer's Cramp

Healthy Volunteer

HV

Condition(s):

Focal Hand 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):

Berardelli A, Rothwell JC, Hallett M, Thompson PD, Manfredi M, Marsden CD. The pathophysiology of primary dystonia. Brain. 1998 Jul;121 ( Pt 7):1195-212.

Bressman SB. Dystonia genotypes, phenotypes, and classification. Adv Neurol. 2004;94:101-7.

Defazio G, Aniello MS, Masi G, Lucchese V, De Candia D, Martino D. Frequency of familial aggregation in primary adult-onset cranial cervical dystonia. Neurol Sci. 2003 Oct;24(3):168-9.

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