Testing rTMS-Induced Neuroplasticity: A Single Case Study of Focal Hand Dystonia

Neural Plast. 2018 May 30:2018:6464896. doi: 10.1155/2018/6464896. eCollection 2018.

Abstract

Focal hand dystonia in musicians is a neurological motor disorder in which aberrant plasticity is caused by excessive repetitive use. This work's purposes were to induce plasticity changes in a dystonic musician through five daily thirty-minute sessions of 1 Hz repetitive transcranial magnetic stimulation (rTMS) applied to the left M1 by using neuronavigated stimulation and to reliably measure the effect of these changes. To this aim, the relationship between neuroplasticity changes and motor recovery was investigated using fine-grained kinematic analysis. Our results suggest a statistically significant improvement in motor coordination both in a task resembling the dystonic-inducing symptoms and in a reach-to-grasp task. This single case study supports the safe and effective use of noninvasive brain stimulation in neurologic patients and highlights the importance of evaluating outcomes in measurable ways. This issue is a key aspect to focus on to classify the clinical expression of dystonia. These preliminary results promote the adoption of kinematic analysis as a valuable diagnostic tool.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Dystonic Disorders / physiopathology
  • Dystonic Disorders / therapy*
  • Fingers
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Motor Cortex / physiopathology*
  • Neuronal Plasticity*
  • Recovery of Function
  • Transcranial Magnetic Stimulation*
  • Treatment Outcome

Supplementary concepts

  • Dystonia, Focal, Task-Specific