[The pathophysiological basis of dystonia].
OBJECTIVE
We review the mechanisms that may involved in the pathophysiology of dystonia.


METHODS
The role of basal ganglia, spinal and brainstem interneurons, and primary motor cortex in dystonia will be discussed. Abnormalities in the discharge pattern of internal pallidum or thalamus, secondary to basal ganglia disorders might be the cause of disbalance between excitatory and inhibitory mechanisms in motor cortex. Other factors such as excessive repetition of a movement or abnormal sensory afferent discharges may be participating in cortical reorganization.


CONCLUSIONS
Overlapping of the cortical representation of dystonic muscles due to enlargement of cortical maps could explain overflow and co-contraction phenomena. The study of the exact role of these factors in each type of dystonia is a challenge for the future that opens the door for new therapeutic approaches.
Artieda
J
J
Servicio de Neurofisiología; Hospital Virgen del Camino, Pamplona, 31008, España. jartieda@unav.es
García De Casasola
M C
MC
Pastor
M A
MA
Alegre
M
M
Urriza
J
J
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001479:Basal Ganglia / Q000503:physiopathology; D001480:Basal Ganglia Diseases / Q000150:complications / Q000503:physiopathology; D001905:Botulinum Toxins / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D004421:Dystonia / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D004576:Electromyography; D005917:Globus Pallidus / Q000503:physiopathology; D006801:Humans; D007395:Interneurons / Q000502:physiology; D008280:Magnetics; D009044:Motor Cortex / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000503:physiopathology; D009433:Neural Inhibition / Q000502:physiology; D009475:Neurons, Afferent / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology; D014055:Tomography, Emission-Computed
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins