Assessment of axial rotation movement in cervical dystonia using cone-beam computed tomography.


Journal

Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877

Informations de publication

Date de publication:
07 2023
Historique:
received: 29 12 2022
revised: 28 06 2023
accepted: 30 06 2023
medline: 21 7 2023
pubmed: 10 7 2023
entrez: 10 7 2023
Statut: ppublish

Résumé

Cervical dystonia is a neurological disorder characterized by involuntary muscle contractions and abnormal postures of the head and neck. Botulinum neurotoxin injection is the first-line treatment. Imaging determination of the cervical segments involved (lower or upper according to the torticollis-torticaput [COL-CAP] Classification) is an aid in determining the muscles to be injected. We aimed to clarify the impact of dystonia on posture and rotational movement of cervical vertebrae in the transverse plane. A comparative study was conducted in a movement disorders department. Ten people with cervical dystonia and 10 matched healthy subjects (without cervical dystonia) were recruited. 3-D images of posture and cervical range of motion in axial rotation in the sitting position were recorded by using a cone-beam CT scanner. Range of rotational motion of the upper cervical spine from the occipital bone to fourth cervical vertebra was measured and compared between the two groups. The head posture analysis showed that the total cervical spine position was more significantly distant from the neutral position for people with dystonia than healthy subjects (p = 0.007). The rotational range of motion of the cervical spine was significantly lower in cervical dystonia participants than in healthy subjects for the total (p = 0.026) and for upper cervical spine (p = 0.004). We demonstrated, by means of cone-beam CT, that the disorganization of movements due to cervical dystonia affected the upper cervical spine and mostly the atlantoaxial joint. The involvement of rotator muscles at this cervical level should be considered more in treatments.

Sections du résumé

BACKGROUND
Cervical dystonia is a neurological disorder characterized by involuntary muscle contractions and abnormal postures of the head and neck. Botulinum neurotoxin injection is the first-line treatment. Imaging determination of the cervical segments involved (lower or upper according to the torticollis-torticaput [COL-CAP] Classification) is an aid in determining the muscles to be injected. We aimed to clarify the impact of dystonia on posture and rotational movement of cervical vertebrae in the transverse plane.
METHODS
A comparative study was conducted in a movement disorders department. Ten people with cervical dystonia and 10 matched healthy subjects (without cervical dystonia) were recruited. 3-D images of posture and cervical range of motion in axial rotation in the sitting position were recorded by using a cone-beam CT scanner. Range of rotational motion of the upper cervical spine from the occipital bone to fourth cervical vertebra was measured and compared between the two groups.
FINDINGS
The head posture analysis showed that the total cervical spine position was more significantly distant from the neutral position for people with dystonia than healthy subjects (p = 0.007). The rotational range of motion of the cervical spine was significantly lower in cervical dystonia participants than in healthy subjects for the total (p = 0.026) and for upper cervical spine (p = 0.004).
INTERPRETATION
We demonstrated, by means of cone-beam CT, that the disorganization of movements due to cervical dystonia affected the upper cervical spine and mostly the atlantoaxial joint. The involvement of rotator muscles at this cervical level should be considered more in treatments.

Identifiants

pubmed: 37429102
pii: S0268-0033(23)00168-7
doi: 10.1016/j.clinbiomech.2023.106037
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106037

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have stated explicitly that there are no conflicts of interest in connection with this work.

Auteurs

Jean-Pierre Bleton (JP)

Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France; Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France. Electronic address: jpbleton@orange.fr.

Raphaël Portero (R)

Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Kévin Zuber (K)

Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Sophie Sangla (S)

Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Jean-Philippe Brandel (JP)

Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Marie Vidailhet (M)

Sorbonne Université, F-75005 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, F-75013 Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM, F-75013 Paris, France.

Serge Mesure (S)

Aix-Marseille University, CNRS, ISM UMR 7287, F-13288 Marseille, France.

Marc Williams (M)

Department of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Julien Savatovsky (J)

Department of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.

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