Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation

Dystonia is a specific type of abnormal movement characterized by involuntary movement, abnormal posture, or both due to persistent or intermittent muscle contractions. At present, symptomatic treatment is mainly used including a combination of psychological and rehabilitation treatments, oral medic...

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Main Authors: WENG Yajing, WU Yi, LIU Gang, CHENG Huilan, XIE Hongyu, TIAN Shan
Format: Article
Language:English
Published: Editorial Office of Rehabilitation Medicine 2022-06-01
Series:康复学报
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Online Access:http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.03012
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author WENG Yajing
WU Yi
LIU Gang
CHENG Huilan
XIE Hongyu
TIAN Shan
author_facet WENG Yajing
WU Yi
LIU Gang
CHENG Huilan
XIE Hongyu
TIAN Shan
author_sort WENG Yajing
collection DOAJ
description Dystonia is a specific type of abnormal movement characterized by involuntary movement, abnormal posture, or both due to persistent or intermittent muscle contractions. At present, symptomatic treatment is mainly used including a combination of psychological and rehabilitation treatments, oral medications, botulinum toxin injections and deep brain stimulation surgery. Existing animal studies suggested that the cerebellum affects dystonia through at least three mechanisms: 1) abnormal cerebellar efferent signal patterns; 2) abnormal connections between the cerebellum and basal ganglia nuclei; 3) abnormalities in the shape or structure of cerebellar cells. The specific role of cerebellum in dystonia has been explored from clinical and pathological observations, neuroelectrophysiology and neuroimaging. In the past, the main function of cerebellum was to maintain body balance and coordinate movement, while dystonia was mainly a disorder of basal ganglia. In recent years, with the development of the "cerebellum-thalamus-cerebral cortex" circuit, the cerebellum has been considered as a new node related to dystonia. As the role of cerebellum in dystonia becomes more and more important and non-invasive brain stimulation techniques have been developed, repetitive transcranial magnetic stimulation (rTMS) for cerebellum is gradually being used. Transcranial magnetic stimulation (TMS) is one of the most widely used neurophysiological techniques in human research. A magnetic field of varying intensity is applied to the central nervous system to generate local currents in the cerebral cortex. rTMS is the traditional mode of stimulation for TMS. Low frequency magnetic stimulation (≤1 Hz) inhibits cortical excitability in the stimulating region, while high frequency stimulation (>1 Hz) increases the excitability of cortical area of stimulation. Theta rhythm burst stimulation (θ rhythm burst stimulation, TBS) is a new type of rTMS. Intermittent TBS (iTBS) can increase excitability of thecortical area, while continuous TBS (cTBS) can inhibit activation of the cerebral cortex. Based on the theory of cerebellar-brain inhibition, TMS can improve symptoms by modulating cerebellar-brain inhibition. Stimulation of the cerebellar cortex by iTBS can inhibit the development of subsequent associative plasticity in the motor cortex, whereas inhibition of the cerebellar cortex by cTBS can enhance subsequent plasticity in the motor cortex. Therefore, cerebellum has gradually become a new regulatory target of higher brain functional stimulation.
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series 康复学报
spelling doaj-art-c6f0d2316da7478f9a7caf495d7f83082025-01-14T10:07:48ZengEditorial Office of Rehabilitation Medicine康复学报2096-03282022-06-013227928428090268Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic StimulationWENG YajingWU YiLIU GangCHENG HuilanXIE HongyuTIAN ShanDystonia is a specific type of abnormal movement characterized by involuntary movement, abnormal posture, or both due to persistent or intermittent muscle contractions. At present, symptomatic treatment is mainly used including a combination of psychological and rehabilitation treatments, oral medications, botulinum toxin injections and deep brain stimulation surgery. Existing animal studies suggested that the cerebellum affects dystonia through at least three mechanisms: 1) abnormal cerebellar efferent signal patterns; 2) abnormal connections between the cerebellum and basal ganglia nuclei; 3) abnormalities in the shape or structure of cerebellar cells. The specific role of cerebellum in dystonia has been explored from clinical and pathological observations, neuroelectrophysiology and neuroimaging. In the past, the main function of cerebellum was to maintain body balance and coordinate movement, while dystonia was mainly a disorder of basal ganglia. In recent years, with the development of the "cerebellum-thalamus-cerebral cortex" circuit, the cerebellum has been considered as a new node related to dystonia. As the role of cerebellum in dystonia becomes more and more important and non-invasive brain stimulation techniques have been developed, repetitive transcranial magnetic stimulation (rTMS) for cerebellum is gradually being used. Transcranial magnetic stimulation (TMS) is one of the most widely used neurophysiological techniques in human research. A magnetic field of varying intensity is applied to the central nervous system to generate local currents in the cerebral cortex. rTMS is the traditional mode of stimulation for TMS. Low frequency magnetic stimulation (≤1 Hz) inhibits cortical excitability in the stimulating region, while high frequency stimulation (>1 Hz) increases the excitability of cortical area of stimulation. Theta rhythm burst stimulation (θ rhythm burst stimulation, TBS) is a new type of rTMS. Intermittent TBS (iTBS) can increase excitability of thecortical area, while continuous TBS (cTBS) can inhibit activation of the cerebral cortex. Based on the theory of cerebellar-brain inhibition, TMS can improve symptoms by modulating cerebellar-brain inhibition. Stimulation of the cerebellar cortex by iTBS can inhibit the development of subsequent associative plasticity in the motor cortex, whereas inhibition of the cerebellar cortex by cTBS can enhance subsequent plasticity in the motor cortex. Therefore, cerebellum has gradually become a new regulatory target of higher brain functional stimulation.http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.03012dystoniacerebellumtranscranial magnetic stimulationcerebellar-cerebral inhibitiontheta rhythm burst stimulationintermittent TBScontinuous TBS
spellingShingle WENG Yajing
WU Yi
LIU Gang
CHENG Huilan
XIE Hongyu
TIAN Shan
Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
康复学报
dystonia
cerebellum
transcranial magnetic stimulation
cerebellar-cerebral inhibition
theta rhythm burst stimulation
intermittent TBS
continuous TBS
title Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
title_full Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
title_fullStr Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
title_full_unstemmed Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
title_short Role of Cerebellum in the Treatment of Dystonia and Application of Cerebellum Transcranial Magnetic Stimulation
title_sort role of cerebellum in the treatment of dystonia and application of cerebellum transcranial magnetic stimulation
topic dystonia
cerebellum
transcranial magnetic stimulation
cerebellar-cerebral inhibition
theta rhythm burst stimulation
intermittent TBS
continuous TBS
url http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.03012
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