Sensory tricks

Although the hypothesis that an underlying defect in somatosensory processing could facilitate a quintessentially motor phenomenon such as dystonia initially sounded counterintuitive or too speculative to many, there is now a substantial body of evidence pointing to altered proprioceptive or tactile sensory processing and sensory-motor integration as central to the pathophysiology of dystonia.^1,2 The involvement of sensory-motor integration in the basic mechanisms of dystonia is clearly evoked by clinical features such as the geste antagoniste (also known as sensory trick) that our patients with cervical or cranial dystonia deploy regularly. The fact that the geste antagoniste, which in most cases is the combination of an active movement and tactile or proprioceptive stimulation provoked or facilitated by the same movement, is probably the most efficient, even if strikingly transient, remedy to counteract dystonia speaks in favor of the centrality of sensory-motor integration in the pathophysiology of dystonia. An essential component of motor control is the ability to sense the position (proprioception) and movement (kinesthesia) of our body.