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Su J, Hu Y, Djibo IM, Chen S, Pan Y, Zhang X, Pan L, Jin L, Teng F. Pivotal role of obliquus capitis inferior in torticaput revealed by single-photon emission computed tomography. J Neural Transm (Vienna) 2022; 129:311-317. [PMID: 35129677 DOI: 10.1007/s00702-022-02469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
Torticaput is the most common primary form of cervical dystonia (CD). Obliquus capitis inferior (OCI) plays a major role in ipsilateral rotation of the head. The present study aimed to use single-photon emission computed tomography (SPECT/CT) to determine the involvement of OCI in torticaput and in torticaput associated with no-no tremor. We retrospectively analyzed the SPECT/CT images of 60 patients with torticaput as the main abnormal posture and ranked the affected muscles. The affected muscles in patients with no-no tremor were also ranked. The correlation between the radioactivity of OCI and the thickness of OCI measured by ultrasonography was analyzed. The agreement between SPECT/CT and electromyography in detecting OCI was also analyzed. After sternocleidomastoid muscle (81.7%), OCI was the second most affected muscle (70.0%) in torticaput, followed by splenius capitis (63.3%). In 23 patients with no-no tremor, OCI (78.3%) and sternocleidomastoid muscle (78.3%) were the most frequently affected muscles, followed by splenius capitis (69.6%). Furthermore, bilateral muscle involvement was commonly seen in patients with no-no tremor, especially for OCI (12/23) and sternocleidomastoid muscle (11/23). A positive correlation was found between the radioactivity and thickness of OCI (r = 0.330, P < 0.001). The total agreement rate between SPECT/CT and electromyography in the diagnosis of OCI excitement was 94.0%, with kappa value = 0.866 (P < 0.001). OCI plays a critical role in torticaput and no-no tremor. SPECT/CT could be a practical tool to help clinicians detect abnormally excited OCI.
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Affiliation(s)
- Junhui Su
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Yaowen Hu
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Issa Malam Djibo
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Shuzhen Chen
- Department of Nuclear Medicine, School of Medicine, Tongji Hospital, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Yougui Pan
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Xiaolong Zhang
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Lizhen Pan
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Lingjing Jin
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China.,Department of Neurology and Neurological Rehabilitation, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, 200092, China
| | - Fei Teng
- Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
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Jost WH, Tatu L, Pandey S, Sławek J, Drużdż A, Biering-Sørensen B, Altmann CF, Kreisler A. Frequency of different subtypes of cervical dystonia: a prospective multicenter study according to Col-Cap concept. J Neural Transm (Vienna) 2019; 127:45-50. [PMID: 31828512 DOI: 10.1007/s00702-019-02116-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/05/2019] [Indexed: 11/30/2022]
Abstract
Patients with cervical dystonia (CD) may present with head and/or neck movements in the coronal, sagittal or transverse plane. According to the Col-Cap concept, CD postures are classified in torti-, latero-, ante- and retrocollis/caput patterns. The frequency of these different subtypes has to be evaluated. Between January and June 2019, we examined 306 patients (55.5 ± 13.1 years, 67% female) with CD according to the Col-Cap concept. They were all treated with botulinum toxin. This prospective study took place in seven different movement disorder centers. The most common primary form was torticaput (49%), the second most common was laterocaput (16.7%). All other subtypes were less than 10% of the study population. Pure forms were observed in 16.3% of patients only. Torticaput was combined in 46% with laterocaput, and in 20.7% with retrocaput. Laterocaput was combined mainly with torticaput (45.1%), laterocollis (33.2%) or retrocaput (23.5%). Shift forms were found in 14.7%, but diagnosed only in 3.9%. On average, the patients had 2.51 (± SD 1.09) subtypes each. Tremor was observed in 55.6%. The mean number of injected muscles was 4.4 (SD 1.6). The most often injected muscles were splenius capitis (83%), sternocleidomatoideus (79.1%), and upper trapezius (58.5%). This is the first multicenter study to examine the frequency of different subtypes of CD according to the Col-Cap concept. The caput subforms are more common than the cervical types, with torticaput as the most common one. Shift forms were diagnosed less often than described. Pure forms are very rare, combinations of 2-6 subtypes are common (83.7%). Sternocleidomatoideus, splenius capitis and trapezius muscles were still injected most often, but the muscles rarely injected in the past such as levator scapulae (48.7%), obliquus capitis inferior (35.3%) and longissimus (16.7%) were considered quite often. Since optimal therapy results depend on the injection of the right muscles, the correct classification should optimize the treatment outcome.
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Affiliation(s)
- Wolfgang H Jost
- Parkinson-Klinik Ortenau, Kreuzbergstr. 12, 77709, Wolfach, Germany.
| | - Laurent Tatu
- Department of Neuromuscular Diseases, CHRU Besançon, University of Franche-Comté, Besançon, France.,Department of Anatomy, CHRU Besançon, University of Franche-Comté, Besançon, France
| | - Sanjay Pandey
- Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, India
| | - Jaroslaw Sławek
- Department of Neurological-Psychiatric Nursing, Medical University of Gdańsk, Gdańsk, Poland.,Department of Neurology, St. Adalbert Hospital, Gdańsk, Poland
| | - Artur Drużdż
- Department of Neurology, Municipal Hospital, Poznan, Poland
| | - Bo Biering-Sørensen
- Movement Disorder Clinic, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | | | - Alexandre Kreisler
- Service de Neurologie et Pathologie du Mouvement, CHRU de Lille, Lille, France
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