Cervical dystonia: A neural integrator disorder

Aasef G. Shaikh, David Samuel Zee, J. Douglas Crawford, Hyder A. Jinnah

Research output: Contribution to journalArticle

Abstract

Ocular motor neural integrators ensure that eyes are held steady in straight-ahead and eccentric positions of gaze. Abnormal function of the ocular motor neural integrator leads to centripetal drifts of the eyes with consequent gaze-evoked nystagmus. In 2002 a neural integrator, analogous to that in the ocular motor system, was proposed for the control of head movements. Recently, a counterpart of gaze-evoked eye nystagmus was identified for head movements; in which the head could not be held steady in eccentric positions on the trunk. These findings lead to a novel pathophysiological explanation in cervical dystonia, which proposed that the abnormalities of head movements stem from a malfunctioning head neural integrator, either intrinsically or as a result of impaired cerebellar, basal ganglia, or peripheral feedback. Here we briefly recapitulate the history of the neural integrator for eye movements, then further develop the idea of a neural integrator for head movements, and finally discuss its putative role in cervical dystonia. We hypothesize that changing the activity in an impaired head neural integrator, by modulating feedback, could treat dystonia.

Original languageEnglish (US)
Pages (from-to)2590-2599
Number of pages10
JournalBrain
Volume139
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Torticollis
Head Movements
Head
Dystonia
Eye Movements
Basal Ganglia
Head Movement
History

Keywords

  • cerebellum
  • integrator
  • midbrain
  • nystagmus
  • tremor

ASJC Scopus subject areas

  • Medicine(all)
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Shaikh, A. G., Zee, D. S., Crawford, J. D., & Jinnah, H. A. (2016). Cervical dystonia: A neural integrator disorder. Brain, 139(10), 2590-2599. https://doi.org/10.1093/brain/aww141

Cervical dystonia : A neural integrator disorder. / Shaikh, Aasef G.; Zee, David Samuel; Crawford, J. Douglas; Jinnah, Hyder A.

In: Brain, Vol. 139, No. 10, 01.10.2016, p. 2590-2599.

Research output: Contribution to journalArticle

Shaikh, AG, Zee, DS, Crawford, JD & Jinnah, HA 2016, 'Cervical dystonia: A neural integrator disorder', Brain, vol. 139, no. 10, pp. 2590-2599. https://doi.org/10.1093/brain/aww141
Shaikh AG, Zee DS, Crawford JD, Jinnah HA. Cervical dystonia: A neural integrator disorder. Brain. 2016 Oct 1;139(10):2590-2599. https://doi.org/10.1093/brain/aww141
Shaikh, Aasef G. ; Zee, David Samuel ; Crawford, J. Douglas ; Jinnah, Hyder A. / Cervical dystonia : A neural integrator disorder. In: Brain. 2016 ; Vol. 139, No. 10. pp. 2590-2599.
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