title: Corticospinal excitability in patients with secondary dystonia due to focal lesions of the basal ganglia and thalamus.
abstract: OBJECTIVE
  To investigate the possible correlations between clinico-radiological features and pathophysiological mechanisms in patients with dystonia secondary to focal brain lesions.
  
  
  METHODS
  Single and paired-pulse transcranial magnetic stimulation was used to assess corticospinal excitability in 10 patients (4 females; mean age 61) and a group of normal controls. Active threshold, latency and amplitude of motor evoked potentials (MEPs), silent period (SP) duration and short-interval intracortical inhibition (SICI) were evaluated.
  
  
  RESULTS
  Patients with lesions involving the putamen and caudate presented with dystonic postures at rest. TMS assessment in these subjects showed increased MEP amplitude on the affected side and a bilateral decrease of SP duration and SICI. When the lesion spared the putamen and caudate, mainly involving the thalamus, the clinical picture was dominated by slow repetitive involuntary movements and tremor. In the affected side of these subjects the MEP amplitude was reduced and the MEP threshold was increased.
  
  
  CONCLUSIONS
  When putamen and caudate were lesioned, the patients presented with dystonic postures at rest; furthermore the patients showed changes of corticospinal excitability in comparison to both healthy subjects and other dystonic patients.
  
  
  CONCLUSIONS
  There are correlations between type of dystonia, site of the lesion and neurophysiological findings.
authors.affiliation: Institute of Neurology, Department of Neurosciences, Ophthalmology and Genetics, University of Genova, Largo Daneo 3, 16132 Genova, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trompetto
authors.forename: Laura
authors.initials: L
authors.lastname: Avanzino
authors.forename: Lucio
authors.initials: L
authors.lastname: Marinelli
authors.forename: Laura
authors.initials: L
authors.lastname: Mori
authors.forename: Elisa
authors.initials: E
authors.lastname: Pelosin
authors.forename: Luca
authors.initials: L
authors.lastname: Roccatagliata
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
mesh_terms: D017668:Age of Onset; D000368:Aged; D001480:Basal Ganglia Diseases / Q000503:physiopathology*; D002421:Caudate Nucleus / Q000503:physiopathology; D004421:Dystonia / Q000209:etiology* / Q000503:physiopathology*; D004558:Electric Stimulation; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009119:Muscle Contraction / Q000502:physiology; D009460:Neurologic Examination; D011699:Putamen / Q000503:physiopathology; D011712:Pyramidal Tracts / Q000503:physiopathology*; D013786:Thalamic Diseases / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D050781:Transcranial Magnetic Stimulation; D014202:Tremor / Q000503:physiopathology