Neurophysiology of dystonia: The role of inhibition

The pathophysiology of dystonia has been best studied in patients with focal hand dystonia. A loss of inhibitory function has been demonstrated at spinal, brainstem and cortical levels. Many cortical circuits seem to be involved. One consequence of the loss of inhibition is a failure of surround inhibition, and this appears to directly lead to overflow and unwanted muscle spasms. There are mild sensory abnormalities and deficits in sensorimotor integration; these also might be explained by a loss of inhibition. Increasing inhibition may be therapeutic. A possible hypothesis is that there is a genetic loss of inhibitory interneurons in dystonia and that this deficit is a substrate on which other factors can act to produce dystonia. This article is part of a Special Issue entitled “Advances in dystonia”.

Research Highlights
► Dystonia is characterized by loss of inhibition throughout the neuraxis.
► Loss of surround inhibition leads to overflow and muscle spasms.
► Mild sensory abnormalities in dystonia may also be due to loss of inhibition.