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Writer's cramp: restoration of striatal D2-binding after successful biofeedback-based sensorimotor training
Hans J Berger1, Sieberen P van der Werf, Casper A Horstink
1Department of Medical Psychology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. h.berger@neuro.umcn.nl
Introduction:
Previous studies of writer's cramp have detected cerebral sensorimotor abnormalities in this disorder and, more specifically, a reduced striatal D2-binding as assessed by [(123)I]IBZM SPECT. However, empirical data were lacking about the influence of effective biofeedback-based sensorimotor training on D2 receptor binding.
Methods:
To determine whether there is a restoration of D2-binding after successful sensorimotor treatment, pre- and posttreatment SPECTs were compared in five patients with writer's cramp and correlated with improvement in handwriting.
Results:
After treatment, the clinical and electromyographic picture appeared substantially improved connected with a significant increase in D2-binding to nearly normal levels similar to normative data in age/sex-matched healthy subjects.
Conclusion:
The current study supported the view that writer's cramp results from a plastic adaptation of a rectifiable nigrostriatal dopaminergic system and that effective sensorimotor training leads to increased efficacy of striatal dopaminergic transmission.