Motor overflow and mirror dystonia

Oraporn Sitburana, Laura Wu, James K. Sheffield, Anthony Davidson, Joseph Jankovic

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Motor overflow is an unintentional muscle contraction which accompanies, but is anatomically distinct from the primary dystonic movement. This phenomenological nosology has not been systematically studied in focal hand dystonia (FHD). We conducted a prospective, case-control study to characterize motor overflow and mirror dystonia in patients with FHD. We compared the performance of 30 patients with FHD and 40 healthy controls on a variety of motor tasks, such as writing, drawing a spiral, straight line and a sine wave, repetitive wrist flexion-extension, finger tapping, hand grasping, hand pronation-supination, and a finger-to-nose task with each hand. The assessments were videotaped, the edited video segments were randomized, and an independent investigator who was "blind" to the subject's diagnosis rated the ipsilateral and contralateral overflow and mirror dystonia twice, 6 months apart. Using the mean of the two ratings, ipsilateral overflow was identified in 8.5 ± 2.1 (28%) patients and in 1.5 ± 0.7 (4%) controls (p < 0.001), contralateral overflow in 2.5 ± 0.7 (8%) patients and in 1.5 ± 0.7 (4%) of controls (p = 0.138), and mirror movement in 20.0 ± 0.0 (67%) of patients and in 15.5 ± 4.9 (39%) of controls (p = 0.001). There was a statistically significant correlation of dystonia and overflow score (Pearson's r 0.713, p < 0.001). The relatively high frequency of ipsilateral overflow and mirror dystonia in patients with FHD has both pathophysiological and therapeutic implications. In this study, the severity of dystonia was significantly correlated with motor overflow in multiple tasks.

Original languageEnglish (US)
Pages (from-to)758-761
Number of pages4
JournalParkinsonism and Related Disorders
Volume15
Issue number10
DOIs
StatePublished - Dec 2009
Externally publishedYes

Fingerprint

Dystonia
Hand
Fingers
Pronation
Supination
Muscle Contraction
Wrist
Nose
Case-Control Studies
Research Personnel
Focal Task-Specific Dystonia

Keywords

  • Dystonia
  • Focal hand dystonia
  • Mirror dystonia
  • Motor overflow

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Sitburana, O., Wu, L., Sheffield, J. K., Davidson, A., & Jankovic, J. (2009). Motor overflow and mirror dystonia. Parkinsonism and Related Disorders, 15(10), 758-761. https://doi.org/10.1016/j.parkreldis.2009.05.003

Motor overflow and mirror dystonia. / Sitburana, Oraporn; Wu, Laura; Sheffield, James K.; Davidson, Anthony; Jankovic, Joseph.

In: Parkinsonism and Related Disorders, Vol. 15, No. 10, 12.2009, p. 758-761.

Research output: Contribution to journalArticle

Sitburana, O, Wu, L, Sheffield, JK, Davidson, A & Jankovic, J 2009, 'Motor overflow and mirror dystonia', Parkinsonism and Related Disorders, vol. 15, no. 10, pp. 758-761. https://doi.org/10.1016/j.parkreldis.2009.05.003
Sitburana, Oraporn ; Wu, Laura ; Sheffield, James K. ; Davidson, Anthony ; Jankovic, Joseph. / Motor overflow and mirror dystonia. In: Parkinsonism and Related Disorders. 2009 ; Vol. 15, No. 10. pp. 758-761.
@article{dba88d7ef3e04309b2a474143b5eae47,
title = "Motor overflow and mirror dystonia",
abstract = "Motor overflow is an unintentional muscle contraction which accompanies, but is anatomically distinct from the primary dystonic movement. This phenomenological nosology has not been systematically studied in focal hand dystonia (FHD). We conducted a prospective, case-control study to characterize motor overflow and mirror dystonia in patients with FHD. We compared the performance of 30 patients with FHD and 40 healthy controls on a variety of motor tasks, such as writing, drawing a spiral, straight line and a sine wave, repetitive wrist flexion-extension, finger tapping, hand grasping, hand pronation-supination, and a finger-to-nose task with each hand. The assessments were videotaped, the edited video segments were randomized, and an independent investigator who was {"}blind{"} to the subject's diagnosis rated the ipsilateral and contralateral overflow and mirror dystonia twice, 6 months apart. Using the mean of the two ratings, ipsilateral overflow was identified in 8.5 ± 2.1 (28{\%}) patients and in 1.5 ± 0.7 (4{\%}) controls (p < 0.001), contralateral overflow in 2.5 ± 0.7 (8{\%}) patients and in 1.5 ± 0.7 (4{\%}) of controls (p = 0.138), and mirror movement in 20.0 ± 0.0 (67{\%}) of patients and in 15.5 ± 4.9 (39{\%}) of controls (p = 0.001). There was a statistically significant correlation of dystonia and overflow score (Pearson's r 0.713, p < 0.001). The relatively high frequency of ipsilateral overflow and mirror dystonia in patients with FHD has both pathophysiological and therapeutic implications. In this study, the severity of dystonia was significantly correlated with motor overflow in multiple tasks.",
keywords = "Dystonia, Focal hand dystonia, Mirror dystonia, Motor overflow",
author = "Oraporn Sitburana and Laura Wu and Sheffield, {James K.} and Anthony Davidson and Joseph Jankovic",
year = "2009",
month = "12",
doi = "10.1016/j.parkreldis.2009.05.003",
language = "English (US)",
volume = "15",
pages = "758--761",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",
number = "10",

}

TY - JOUR

T1 - Motor overflow and mirror dystonia

AU - Sitburana, Oraporn

AU - Wu, Laura

AU - Sheffield, James K.

AU - Davidson, Anthony

AU - Jankovic, Joseph

PY - 2009/12

Y1 - 2009/12

N2 - Motor overflow is an unintentional muscle contraction which accompanies, but is anatomically distinct from the primary dystonic movement. This phenomenological nosology has not been systematically studied in focal hand dystonia (FHD). We conducted a prospective, case-control study to characterize motor overflow and mirror dystonia in patients with FHD. We compared the performance of 30 patients with FHD and 40 healthy controls on a variety of motor tasks, such as writing, drawing a spiral, straight line and a sine wave, repetitive wrist flexion-extension, finger tapping, hand grasping, hand pronation-supination, and a finger-to-nose task with each hand. The assessments were videotaped, the edited video segments were randomized, and an independent investigator who was "blind" to the subject's diagnosis rated the ipsilateral and contralateral overflow and mirror dystonia twice, 6 months apart. Using the mean of the two ratings, ipsilateral overflow was identified in 8.5 ± 2.1 (28%) patients and in 1.5 ± 0.7 (4%) controls (p < 0.001), contralateral overflow in 2.5 ± 0.7 (8%) patients and in 1.5 ± 0.7 (4%) of controls (p = 0.138), and mirror movement in 20.0 ± 0.0 (67%) of patients and in 15.5 ± 4.9 (39%) of controls (p = 0.001). There was a statistically significant correlation of dystonia and overflow score (Pearson's r 0.713, p < 0.001). The relatively high frequency of ipsilateral overflow and mirror dystonia in patients with FHD has both pathophysiological and therapeutic implications. In this study, the severity of dystonia was significantly correlated with motor overflow in multiple tasks.

AB - Motor overflow is an unintentional muscle contraction which accompanies, but is anatomically distinct from the primary dystonic movement. This phenomenological nosology has not been systematically studied in focal hand dystonia (FHD). We conducted a prospective, case-control study to characterize motor overflow and mirror dystonia in patients with FHD. We compared the performance of 30 patients with FHD and 40 healthy controls on a variety of motor tasks, such as writing, drawing a spiral, straight line and a sine wave, repetitive wrist flexion-extension, finger tapping, hand grasping, hand pronation-supination, and a finger-to-nose task with each hand. The assessments were videotaped, the edited video segments were randomized, and an independent investigator who was "blind" to the subject's diagnosis rated the ipsilateral and contralateral overflow and mirror dystonia twice, 6 months apart. Using the mean of the two ratings, ipsilateral overflow was identified in 8.5 ± 2.1 (28%) patients and in 1.5 ± 0.7 (4%) controls (p < 0.001), contralateral overflow in 2.5 ± 0.7 (8%) patients and in 1.5 ± 0.7 (4%) of controls (p = 0.138), and mirror movement in 20.0 ± 0.0 (67%) of patients and in 15.5 ± 4.9 (39%) of controls (p = 0.001). There was a statistically significant correlation of dystonia and overflow score (Pearson's r 0.713, p < 0.001). The relatively high frequency of ipsilateral overflow and mirror dystonia in patients with FHD has both pathophysiological and therapeutic implications. In this study, the severity of dystonia was significantly correlated with motor overflow in multiple tasks.

KW - Dystonia

KW - Focal hand dystonia

KW - Mirror dystonia

KW - Motor overflow

UR - http://www.scopus.com/inward/record.url?scp=70450223541&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70450223541&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2009.05.003

DO - 10.1016/j.parkreldis.2009.05.003

M3 - Article

VL - 15

SP - 758

EP - 761

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

IS - 10

ER -