Impairment of sleep homeostasis in cervical dystonia patients

Alterations in brain plasticity seem to play a role in the pathophysiology of cervical dystonia (CD). Since evidences indicate that sleep regulates brain plasticity, we hypothesized that an alteration in sleep homeostatic mechanisms may be involved in the pathogenesis of CD. We explored sleep in control subjects (CTL) and CD patients before (T(pre-BoNT)) and after (T(post-BoNT)) botulinum toxin (BoNT) treatment. A physiological slow wave activity (SWA) power decrease throughout the night was observed in CTL but not in CD at T(pre-BoNT). BoNT restored the physiological SWA decrease in CD at T(post-BoNT). Furthermore, in the first part of the night, CD at T(post-BNT) showed a frontal increase and parietal decrease in SWA power compared to CD at T(pre-BoNT), with a SWA distribution comparable to that observed in CTL. Our data highlighted a pathophysiological relationship between SWA during sleep and CD and provided novel insight into the transient central plastic effect of BoNT.