Journal: Drug Invention Today

Article Id: JPRS-Pcol-00002786
Title: Pathophysiological mechanisms of spasmodic torticollis
Category: Pharmacology
Section: Research Article
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    Aim: Spastic torticollis, like other forms of local muscular dystonia, refers to the most complex and least studied forms of extrapyramidal disorders. Pathogenetic mechanisms of spastic torticollis development are still not sufficiently understood. It is known that muscle hyperactivity, characteristic of focal dystonia, is mediated by neurophysiological disorders in the basal ganglia, brainstem, and cortical zones. Forced tilt of the head can be associated with a violation of the functional balance of different parts of the motor cortical-subcortical circle and their supporting neurotransmitter systems. These mechanisms provide for a special role for sensory control and sensory influences on the course and variability of hyperkinesia. Materials and Method: One of the most important achievements of neurophysiology was the discovery of systems that perform complex functions of maintenance of a coordinated distribution of muscle tone by regulating the afferent influx. Discussion of the role of central and peripheral factors in the pathogenesis of spastic torticollis has predetermined an in-depth study of reflex excitability. The authors attempted to study segmental-suprasegmental interactions with spastic crooked by means of neurophysiological methods, in particular, studies of polysynaptic reflex excitability and induced brain potentials, as well as transcranial magnetic stimulation. Results: The paper presents the results of a clinical and electroneurophysiological examination of 106 patients with spastic torticollis. The study of the spinal-stem polysynaptic reflex and the phenomenon of inhibition convincingly showed that spastic torticollis is accompanied by various integrative reactions of the supraspinal structures. It was revealed that the spinal barrel polysynaptic reflex and the phenomenon of inhibition are as more stable as greater the degree of clinical manifestations of hyperkinesis is. The study of evoked acoustic stem potentials and evoked somatosensory potentials revealed a grosser distortion of the main parameters in the group of patients with tonic–clonic form of spasmodic torticollis. The use of transcranial magnetic stimulation made it possible to obtain a quantitative characteristic of the functional state of the pyramidal tract in spastic torticollis and revealed a decrease in inhibitory processes in the motor parts of the cerebral cortex and an increased readiness for reflex responses. Conclusion: These studies showed that spastic torticollis is accompanied by a violation of the entire system of movement control, which is manifested by increased excitability of the reflex arches of the brainstem, changes in reactions to afferent stimuli, and a decrease in inhibitory processes. These disorders are more pronounced in the tonic–clonic form of spasmodic torticollis. Diagnostic value of clinical and instrumental tests including the investigation of the spinal-stem polysynaptic reflex and the period of inhibition, and induced brain potentials (acoustic and somatosensory) is substantiated for assessing the severity, course, and prognosis of spasmodic torticollis.

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    Author(s) Name:

    Аl’mir R. Abashev1 *, Lilia R. Mindubaeva2 , Georgy A. Ivanichev2 , Guzel M. Karimova1,2

    Affiliation(s) Name:

    1 Department of Neurology, Reflexotherapy and Osteopathy, Kazan, Russian Federation,

    2 Department of Neurology and Reflexology of the Kazan State Medical Academy, Kazan, Russian Federation

    *Corresponding author: Аl’mir R. Abashev, Department of Neurology, Reflexotherapy and Osteopathy, Butlerova Street, 36, Kazan - 420 012, Russian Federation

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    Аl’mir R. Abashev1 *, Lilia R. Mindubaeva2 , Georgy A. Ivanichev2 , Guzel M. Karimova1,2

    Title:Pathophysiological mechanisms of spasmodic torticollis
    Journal:Drug Invention Today
    Vol(issue):10 (October [ Special Issue 2 ])
    Page No: (2944-2948)
  • Experimental Methods Keywords

    Methodology:Pathophysiological mechanisms
    Research Materials:spasmodic torticollis


Evoked brain potentials Polysynaptic reflex excitability Spasmodic torticollis Spinal-columnar polysynaptic reflex Transcranial magnetic stimulation

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