The effect of cognitive task on postural stability in cervical dystonia.


Journal

Arquivos de neuro-psiquiatria
ISSN: 1678-4227
Titre abrégé: Arq Neuropsiquiatr
Pays: Germany
ID NLM: 0125444

Informations de publication

Date de publication:
09 2020
Historique:
received: 29 11 2019
accepted: 24 03 2020
pubmed: 2 7 2020
medline: 30 12 2020
entrez: 2 7 2020
Statut: ppublish

Résumé

Cervical dystonia (CD) is the most common form of focal dystonia. It is not known exactly whether abnormal head postures in cervical dystonia cause balance problems. Dual-tasking is a common every-day life situation. We aimed to evaluate postural stability (PS) in patients with CD and the effect of cognitive task on PS. As a secondary aim, we evaluated the effect of onabotulinum toxin A (BoNT) injection on PS. A total of 24 patients with CD who were on BoNT treatment for at least one year and 23 healthy controls were included. Posturographic analyses were carried out in all the subjects on static posturography platform under four different conditions: eyes open, eyes closed, tandem stance and cognitive task. In patients, posturographic analysis was carried out just before the BoNT injections and was repeated four weeks later. Before treatment, the anterior-posterior sway was significantly higher in CD patients with the eyes open condition compared to the controls (p=0.03). Cognitive task significantly affected several sway velocities. Tandem stance significantly affected many sway parameters, whereas the eyes closed condition did not. After treatment, only two parameters in tandem stance and one in cognitive task improved within the patient group, in a pairwise comparison. Postural control is impaired in CD patients probably due to the impaired proprioceptive and sensorimotor integration. In reference to dual task theories possibly due to divided attention and task prioritization, cognitive dual-task and harder postural task disturbes the PS in these patients.

Sections du résumé

BACKGROUND
Cervical dystonia (CD) is the most common form of focal dystonia. It is not known exactly whether abnormal head postures in cervical dystonia cause balance problems. Dual-tasking is a common every-day life situation.
OBJECTIVE
We aimed to evaluate postural stability (PS) in patients with CD and the effect of cognitive task on PS. As a secondary aim, we evaluated the effect of onabotulinum toxin A (BoNT) injection on PS.
METHODS
A total of 24 patients with CD who were on BoNT treatment for at least one year and 23 healthy controls were included. Posturographic analyses were carried out in all the subjects on static posturography platform under four different conditions: eyes open, eyes closed, tandem stance and cognitive task. In patients, posturographic analysis was carried out just before the BoNT injections and was repeated four weeks later.
RESULTS
Before treatment, the anterior-posterior sway was significantly higher in CD patients with the eyes open condition compared to the controls (p=0.03). Cognitive task significantly affected several sway velocities. Tandem stance significantly affected many sway parameters, whereas the eyes closed condition did not. After treatment, only two parameters in tandem stance and one in cognitive task improved within the patient group, in a pairwise comparison.
CONCLUSIONS
Postural control is impaired in CD patients probably due to the impaired proprioceptive and sensorimotor integration. In reference to dual task theories possibly due to divided attention and task prioritization, cognitive dual-task and harder postural task disturbes the PS in these patients.

Identifiants

pubmed: 32609289
pii: S0004-282X2020005015201
doi: 10.1590/0004-282X20200038
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

549-555

Auteurs

Turgay Demİr (T)

Çukurova University, Faculty of Medicine, Department of Neurology, Adana, Turkey.

Mehmet Balal (M)

Çukurova University, Faculty of Medicine, Department of Neurology, Adana, Turkey.
Çukurova University, Faculty of Medicine, Movement Disorders Unit, Department of Neurology, Adana, Turkey.

Meltem Demİrkİran (M)

Çukurova University, Faculty of Medicine, Department of Neurology, Adana, Turkey.
Çukurova University, Faculty of Medicine, Movement Disorders Unit, Department of Neurology, Adana, Turkey.

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Classifications MeSH