Next Article in Journal
The Natural Fungal Metabolite Beauvericin Exerts Anticancer Activity In Vivo: A Pre-Clinical Pilot Study
Next Article in Special Issue
Neurophysiological Measures of Efficacy and Safety for Botulinum Toxin Injection in Facial and Bulbar Muscles: Special Considerations
Previous Article in Journal
Genetic Divergence and Chemotype Diversity in the Fusarium Head Blight Pathogen Fusarium poae
Article Menu
Issue 9 (September) cover image

Export Article

Open AccessArticle
Toxins 2017, 9(9), 256;

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

Department of Neurology and Clinical Neurophysiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
BioMechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
Department of Neurology, Reinier de Graaf Groep, 2625 AD Delft, The Netherlands
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)
Full-Text   |   PDF [3161 KB, uploaded 23 August 2017]   |  


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

Figure 1a

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material


Share & Cite This Article

MDPI and ACS Style

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.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Toxins EISSN 2072-6651 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top