title: Cortico-cortical inhibition of the motor cortical area projecting to sternocleidomastoid muscle in normals and patients with spasmodic torticollis or essential tremor.
abstract: OBJECTIVE
  To investigate whether the cortico-cortical inhibition originally reported for the human hand motor area is present in the motor cortex for sternocleidomastoid muscle (SCM) and to evaluate the amount of inhibition in spasmodic torticollis and essential tremor.
  
  
  METHODS
  Subjects were 14 normal healthy volunteers, 10 patients with spasmodic torticollis and 5 with essential tremor involving neck muscles. A paired-pulse magnetic stimulation was performed for the SCMs and first dorsal interosseous muscles (FDIs).
  
  
  RESULTS
  In normal subjects, a subthreshold magnetic conditioning stimulus suppressed responses to a suprathreshold magnetic test stimulus when their interval was 1-5 ms in SCM. This indicates that the similar cortico-cortical inhibitory mechanism is present in the motor cortex for SCM as in the hand motor area. In the patients with spasmodic torticollis, the cortico-cortical inhibitory effect was reduced or absent in SCM, but normal in the FDI. In contrast, in patients with essential tremor, normal cortico-cortical inhibition was seen in both the SCM and FDI.
  
  
  CONCLUSIONS
  The cortico-cortical inhibitory mechanisms of the motor cortex for SCM can be studied by a paired-pulse magnetic stimulation method. Our result of reduced cortico-cortical inhibition in torticollis patients suggests abnormal excitability (hyperexcitable or disinhibited) of the motor cortex for SCM in spasmodic torticollis.
authors.affiliation: Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Hanajima
authors.forename: Y
authors.initials: Y
authors.lastname: Ugawa
authors.forename: Y
authors.initials: Y
authors.lastname: Terao
authors.forename: K
authors.initials: K
authors.lastname: Sakai
authors.forename: T
authors.initials: T
authors.lastname: Furubayashi
authors.forename: K
authors.initials: K
authors.lastname: Machii
authors.forename: H
authors.initials: H
authors.lastname: Uesugi
authors.forename: H
authors.initials: H
authors.lastname: Mochizuki
authors.forename: I
authors.initials: I
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D000368:Aged; D003213:Conditioning, Psychological; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009334:Neck Muscles / Q000503:physiopathology*; D009433:Neural Inhibition / Q000502:physiology*; D012016:Reference Values; D009435:Synaptic Transmission / Q000502:physiology*; D014103:Torticollis / Q000503:physiopathology*; D014202:Tremor / Q000503:physiopathology*