Dynamic head-neck stabilization in cervical dystonia

Patrick A. Forbes*, Edo de Bruijn, Sebastiaan W.R. Nijmeijer, Johannes H.T.M. Koelman, Frans C.T. van der Helm, Alfred C. Schouten, Marina A.J. Tijssen, Riender Happee

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
171 Downloads (Pure)


Background: Effective sensorimotor integration is essential to modulate (adapt) neck stabilization strategies in response to varying tasks and disturbances. This study evaluates the hypothesis that relative to healthy controls cervical dystonia patients have an impaired ability to modulate afferent feedback for neck stabilization with changes in the frequency content of mechanical perturbations.

Methods: We applied anterior-posterior displacement perturbations (110 s) on the torso of seated subjects, while recording head-neck kinematics and muscular activity. We compared low bandwidth (0.2–1.2 Hz) and high bandwidth (0.2–8 Hz) perturbations where our previous research showed a profound modulation of stabilization strategies in healthy subjects. Cervical dystonia patients and age matched controls performed two tasks: (1) maintain head forward posture and (2) allow dystonia to dictate head posture.

Findings: Patients and controls demonstrated similar kinematic and muscular responses. Patient modulation was similar to that of healthy controls (P > 0.05); neck stiffness and afferent feedback decreased with high bandwidth perturbations. During the head forward task patients had an increased neck stiffness relative to controls (P < 0.05), due to increased afferent feedback.

Interpretation: The unaffected modulation of head-neck stabilization (both kinematic and muscular) in patients with cervical dystonia does not support the hypothesis of impaired afferent feedback modulation for neck stabilization.

Original languageEnglish
Pages (from-to)120-127
Number of pages8
JournalClinical biomechanics
Publication statusPublished - 1 Feb 2017


  • Cervical dystonia
  • Dystonic posture
  • Head-neck stabilization
  • Neck afferent feedback modulation
  • Sensorimotor integration


Dive into the research topics of 'Dynamic head-neck stabilization in cervical dystonia'. Together they form a unique fingerprint.

Cite this