AUTHOR=McClelland Verity M. , Lin Jean-Pierre 

TITLE=Sensorimotor Integration in Childhood Dystonia and Dystonic Cerebral Palsy—A Developmental Perspective

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.668081

DOI=10.3389/fneur.2021.668081

ISSN=1664-2295

ABSTRACT=Dystonia is a disorder of sensorimotor integration, involving dysfunction within the basal ganglia, cortex, cerebellum or their inter-connections as part of the sensorimotor network.  Some forms of dystonia are also characterised by maladaptive or exaggerated plasticity. Development of the neuronal processes underlying sensorimotor integration is incompletely understood but involves activity-dependent modelling and refining of sensorimotor circuits through processes that are already taking place in utero and which continue through infancy, childhood and into adolescence.
Classical DYT1 dystonia has clinical onset in early childhood, but there is evidence that sensorimotor circuit development may already be disrupted prenatally in this genetic condition.  Dystonic cerebral palsy is a form of acquired dystonia with perinatal onset during a period of rapid neurodevelopment and activity-dependent refinement of sensorimotor networks. However, physiological studies of children with dystonia are sparse.  
This discussion paper addresses the role of neuroplasticity in the development of sensorimotor integration with particular focus on the relevance of these mechanisms for understanding childhood dystonia, dystonic cerebral palsy and implications for therapy selection, including neuromodulation and timing of intervention.