Cervical dystonia, the development of a new diagnostic tool

Spasmodic torticollis, also called cervical dystonia (CD), is characterized by
sustained involuntary muscle contractions leading to debilitating abnormal
postures, pain and twisting movements of the neck. The diagnosis is based on
clinical expertise, as no specific tests are available. Pathophysiology of
dystonia is hypothesised in the basal ganglia and reflected by a common 5-7 Hz
dystonic drive in dystonic muscles.. The first line treatment for spasmodic
torticollis is the intramuscular injection of botuline toxin (BoNT) in the
dystonic muscles. In more complex dystonic neck movements, it is difficult to
differentiate dystonic muscles from muscles compensating the dystonic posture.

The goal of this project is, in co-operation with the TU-delft, to develop a
new diagnostic tool to discriminate dystonic muscles from healthy muscles
contracting compensatory. This would enable us in the future to identify
dystonic muscles more precisely in CD patients and therefore improve the
accuracy of BoNT injections. We hypothesise that this will improve the effect
of BONT treatment in CD patients.

Pilot study to explore the feasibility of 3 dystonia identification methods in
CD patients .

Patients and controls will have to come to the AMC for one day and to the
TuDelft for one day.
In the AMC they will undergo a neurological examination and EMG measurements.
In TU-Delft they will participate in a perturbation experiment and in an
isometric contraction experiment(as described above)
These experiments might lead to minor discomfort but the risks associated with
these experiments are minimal.