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Toxins 2017, 9(9), 256; https://doi.org/10.3390/toxins9090256

Spectral EMG Changes in Cervical Dystonia Patients and the Influence of Botulinum Toxin Treatment

1
Department of Neurology and Clinical Neurophysiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
2
BioMechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
3
Department of Neurology, Reinier de Graaf Groep, 2625 AD Delft, The Netherlands
4
Department of Neurology AB 51, University of Groningen, 9713 GZ Groningen, The Netherlands
These authors contributed to this work equally.
*
Author to whom correspondence should be addressed.
Academic Editors: Jennifer G. Goldman and Codrin Lungu
Received: 4 July 2017 / Revised: 10 August 2017 / Accepted: 14 August 2017 / Published: 23 August 2017
(This article belongs to the Special Issue Muscle Selection for BoNT)
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Abstract

Botulinum toxin (BoNT) injections in the dystonic muscles is the preferred treatment for Cervical Dystonia (CD), but the proper identification of the dystonic muscles remains a challenge. Previous studies showed decreased 8–14 Hz autospectral power in the electromyography (EMG) of splenius muscles in CD patients. Cumulative distribution functions (CDF’s) of dystonic muscles showed increased CDF10 values, representing increased autospectral powers between 3 and 10 Hz, relative to power between 3 and 32 Hz. In this study, we evaluated both methods and investigated the effects of botulinum toxin. Intramuscular EMG recordings were obtained from the splenius, semispinalis, and sternocleidomastoid muscles during standardized isometric tasks in 4 BoNT-naïve CD patients, 12 BoNT-treated patients, and 8 healthy controls. BoNT-treated patients were measured 4–7 weeks after their last BoNT injections and again after 11–15 weeks. We found significantly decreased 8–14 Hz autospectral power in splenius muscles, but not in the semispinalis and sternocleidomastoid muscles of CD patients when compared to healthy controls. CDF10 analysis was superior in demonstrating subtle autospectral changes, and showed increased CDF10 values in all studied muscles of CD patients. These results did not change significantly after BoNT injections. Further studies are needed to investigate the origin of these autospectral changes in dystonia patients, and to assess their potential in muscle selection for BoNT treatment. View Full-Text
Keywords: cervical dystonia; botulinum toxin; EMG; autospectral analysis; muscle selection cervical dystonia; botulinum toxin; EMG; autospectral analysis; muscle selection
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Nijmeijer, S.W.R.; de Bruijn, E.; Verhagen, R.; Forbes, P.A.; Kamphuis, D.J.; Happee, R.; Tijssen, M.A.J.; Koelman, J.H.T.M. Spectral EMG Changes in Cervical Dystonia Patients and the Influence of Botulinum Toxin Treatment. Toxins 2017, 9, 256.

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