Objective: To investigate whether changes in the somatosensory temporal discrimination threshold (STDT) in Parkinson’s disease (PD) and dystonia reflect the involvement of specific neural structures or mechanisms related to tremor, and whether the STDT can discriminate patients with PD, dystonia or essential tremor (ET) with postural arm tremor.

Background: The STDT measures a subject’s ability to discriminate sensory stimuli in the temporal domain and it strongly relies on inhibitory interneurons in the primary somatosensory cortex (S1). Abnormally increased STDT values have been reported in PD and dystonia whereas the STDT in ET is reported to be normal. STDT changes in movement disorders may be caused by the involvement of specific neural structures (S1 , basal ganglia and cerebellum) or might reflect specific mechanisms related to the pathophysiology of motor symptoms.

Methods: We tested the STDT in 223 patients with PD, dystonia and ET. We then compared STDT values in patients with PD and dystonia with tremor with those in patients without tremor. Data were also compared with those of age-matched healthy subjects.

Results: STDT values were high in patients with dystonia and PD but normal in patients with ET. In PD, STDT values were similar in patients with resting or postural tremor and in those without tremor. In dystonia, STDT values were higher in patients with tremor than in those without tremor. The ROC curve showed that STDT discriminates tremor in dystonia from ET.

Conclusions: STDT abnormalities in movement disorders reflect the dysfunction of S1 and the basal ganglia. In PD, STDT abnormalities are not linked to tremor. In dystonia, STDT abnormalities in patients with tremor disclose additional mechanisms related to cerebellar dysfunction. Lastly, STDT may differentiate ET from tremor in dystonia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/somatosensory-temporal-discrimination-in-parkinsons-disease-dystonia-and-essential-tremor-pathophysiological-and-clinical-implications/