Basic and Translational Neuroscience of Childhood-Onset Dystonia: A Control-Theory Perspective

Annu Rev Neurosci. 2018 Jul 8:41:41-59. doi: 10.1146/annurev-neuro-080317-061504. Epub 2018 Feb 28.

Abstract

Dystonia is a collection of symptoms with involuntary muscle activation causing hypertonia, hyperkinetic movements, and overflow. In children, dystonia can have numerous etiologies with varying neuroanatomic distribution. The semiology of dystonia can be explained by gain-of-function failure of a feedback controller that is responsible for stabilizing posture and movement. Because postural control is maintained by a widely distributed network, many different anatomic regions may be responsible for symptoms of dystonia, although all features of dystonia can be explained by uncontrolled activation or hypersensitivity of motor cortical regions that can cause increased reflex gain, inserted postures, or sensitivity to irrelevant sensory variables. Effective treatment of dystonia in children requires an understanding of the relationship between etiology, anatomy, and the specific mechanism of failure of postural stabilization.

Keywords: childhood; control theory; dystonia; feedback control; noise.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Child
  • Dystonic Disorders* / etiology
  • Dystonic Disorders* / therapy
  • Feedback, Physiological*
  • Humans
  • Motor Cortex / physiology
  • Movement*
  • Neurosciences*
  • Posture*