title: Effects of cerebellar theta-burst stimulation on arm and neck movement kinematics in patients with focal dystonia.
abstract: OBJECTIVE
  To investigate the cerebellar inhibitory influence on the primary motor cortex in patients with focal dystonia using a cerebellar continuous theta-burst stimulation protocol (cTBS) and to evaluate any relationship with movement abnormalities.
  
  
  METHODS
  Thirteen patients with focal hand dystonia, 13 patients with cervical dystonia and 13 healthy subjects underwent two sessions: (i) cTBS over the cerebellar hemisphere (real cTBS) and (ii) cTBS over the neck muscles (sham cTBS). The effects of cerebellar cTBS were quantified as excitability changes in the contralateral primary motor cortex, as well as possible changes in arm and neck movements in patients.
  
  
  RESULTS
  Real cerebellar cTBS reduced the excitability in the contralateral primary motor cortex in healthy subjects and in patients with cervical dystonia, though not in patients with focal hand dystonia. There was no correlation between changes in primary motor cortex excitability and arm and neck movement kinematics in patients. There were no changes in clinical scores or in kinematic measures, after either real or sham cerebellar cTBS in patients.
  
  
  CONCLUSIONS
  The reduced cerebellar inhibitory modulation of primary motor cortex excitability in focal dystonia may be related to the body areas affected by dystonia as opposed to being a widespread pathophysiological abnormality.
  
  
  CONCLUSIONS
  The present study yields information on the differential role played by the cerebellum in the pathophysiology of different focal dystonias.
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli (IS), Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bologna
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Paparella
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabbrini
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Leodori
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rocchi
authors.affiliation: Human Motor Control Section, National Institute of Neurological Disorders and Stroke - NINDS, Bethesda, MD, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli (IS), Italy. Electronic address: alfredo.berardelli@uniroma1.it.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
mesh_terms: D000328:Adult; D001132:Arm / Q000503:physiopathology*; D001696:Biomechanical Phenomena / Q000502:physiology; D002531:Cerebellum / Q000503:physiopathology*; D020821:Dystonic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009334:Neck Muscles / Q000503:physiopathology*; D013826:Theta Rhythm / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods
keywords: Cerebellum; Dystonia; Motor control; Transcranial magnetic stimulation