Effects of neck proprioceptive modulation on pallidal network connectivity in dystonia

Cervical dystonia (CD) is the third most common movement disorder affecting 1 million people worldwide. Proprioceptive modulation is the hallmark of contemporary therapies for dystonia, but the mechanism for this intervention is unclear. We studied proprioceptive influence on CD by measuring the spontaneous single-neuron responses and local field potentials (LFP) from the globus pallidus interna (GPi) in 17 CD patients (9 isolated CD and 8 with CD as a feature of generalized dystonia). The goal was to examine how high-frequency neck vibration, a putative modulator of neck proprioception changes pallidal physiology. We found that the neck vibration instantaneously alters the pallidal single neuron activity. We also found that neck vibration modulates pallido-cerebellar connectivity by changing alpha band in LFP recordings. The effects were more robust in those with isolated CD. The vibration also affects pallido-hippocampal connectivity by modulating theta-band power. These effects were more robust in CD with generalized dystonia. Vibration changed LFP only in select pallidal regions. Regions where LFP power was substantially modulated had a prominent proportion of burst subtypes of neurons, compared to pause or tonic subtypes. Such disparity in subtype was absent in regions where the LFP power was not modulated or subtly reduced with neck vibration. When changes in the theta, alpha and beta bands of the LFP recordings were compared against each other in response to vibration, high correlation was observed.