Writer's cramp: Restoration of striatal D2-binding after successful biofeedback-based sensorimotor training

Berger, Hans J.; van der Werf, Sieberen P.; Horstink, Casper A.; Cools, Alexander R.; Oyen, Wim J.; Horstink, Martin W.

doi:10.1016/j.parkreldis.2006.09.003

« Previous Next »Parkinsonism & Related Disorders
Volume 13, Issue 3 , Pages 170-173, April 2007

Writer's cramp: Restoration of striatal D2-binding after successful biofeedback-based sensorimotor training

Hans J. Berger
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Corresponding author. Tel.: +310243613608; fax: +310243613425.
Sieberen P. van der Werf
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
Casper A. Horstink
- Zaart 35, 4819 ED Breda, The Netherlands
Alexander R. Cools
- Department of Psychoneuro-Pharmacology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
Wim J. Oyen
- Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
Martin W. Horstink
- Department of Neurology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

Received 27 June 2006; received in revised form 28 August 2006; accepted 12 September 2006.

Abstract

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 [¹²³I]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.

Keywords: Writer's cramp, Biofeedback, Dopamine, Striatum, [¹²³I]IBZM SPECT