Dystonia treatment Neuroplasticity Holistic therapy for Dystonia




Up to now, primary dystonias have been studied within the frame of an acquired brain injury.  For this reason, their prevention, and even their cure, have been considered impossible.


Could it be that we have been trying to analyze dystonia from the wrong angle?  Perhaps it can’t be cured because it is not an illness, in the same way that autism cannot be cured because it is a condition, a different way of being, of perceiving, living and feeling.


Do dystonia patients have personality characteristics in common?


In the 900 patients evaluated during the creation of this book, many similarities in their personalities can be observed.


It’s quite usual that dystonia patients have close family members with functional autism or ADHD.


I do not agree with defining my patients as dystonics.  What defines them is their personalities, which themselves are very special.  People who develop dystonias are hypersensitive, brilliant, impulsive, and have great determination.  Among the people affected by dystonias we find United Nations politicians, surgeons, athletes, Olympians, company presidents, dancers, famous musicians, artists, and writers.


If 10 million dystonics exist in the world, it is because those genes have reached us, because millions of individuals have survived with them or because those genes were the secret to their survival, including ours.  Every way of being and existing, every interaction, represents the end of a fortunate story that has been able to cross the tunnel of time to win a place in the present.  Dystonics are very physically special.  Their muscles, tendons, and ligaments are stronger and more resistant than normal.  Their bodies can stand enormous muscular tension; in some cases they don’t even stop to sleep, without damaging effects.  They are gifted with great reflexes:  from being hyperactive, the slightest noise wakes them and prepares them to fight or run at a moment’s notice.  There is not the smallest chance that a primitive dystonic would be caught by surprise by a tiger.  Their obsessive and distrustful personality wouldn’t allow them to let their guard down for an instant.  They would make the perfect watchmen.


It is also probable that they were great hunters.  My clients tend to stand out in resistance and strength sports.  One of my clients who was a computer programmer decided at 38 years of age to ride mountain bikes.  Within two years he had become world champion in his category.  His is not an isolated case.  Many dystonics improve by competing in marathons, triathlons, and even Iron Man or extreme Iron Man competitions.  Weightlifting is another thing that they also not only enjoy, but often accomplish at above-normal levels.  There are dystonics in the NHL, NBA and the Grand Slam.  Musicians like Yehudi Menuhim or Glen Gould, who had exceptional coordination, suffered from dystonias, but perhaps it was their special brain structure that allowed them to complete these feats of motor coordination as no one else could.


Dystonics not only stand out in physical activity, but also in the arts and sciences. The composer Robert Schuman, who is considered to be one of the oldest recognized cases of dystonia, was enormously creative, and just like many other great composers, when he started something, he couldn’t put it down until he had finished it.  He was also affected by severe depression during his life. 


Dystonics also tend to be daydreamers.  They don’t pay attention to what doesn’t interest them.  When they become interested in or passionate about something, they can engage in levels of extreme concentration which they retain for long periods of time, which sometimes allows them to reach great heights of creative genius.  This quality frequently allows them to stand out in whatever they take on.  There are no limits to the levels of involvement they put into a project.  Their perseverance makes them achieve whatever they attempt.  Their hypersensitivity and attention to detail make them good analysts.  Many dystonics work as musicians, linguists, code analysts, lawyers, judges, and journalists.  Any solitary activity related to an ability to pay attention to detail, analyze patterns, and look for analogies can be suitable jobs for dystonics.  All these qualities also have a counterpart that can become a problem.  Their extreme sensitivity can cause them to suffer from depression or fear of leaving their home.  They prefer intimate settings with just a few people and suffer from social anxiety when they are in large groups of people.   Their hypersensitivity is not just emotional, but also sensorial; bright lights, noises, and unexpected movements can all make them dizzy, anxious, or even panicky.  Sensitivity might be a good quality for an artist, but it can also be a handicap if the person has to live in a big city, work in customer service, or take on a position of great responsibility.


The same quality that allows dystonics to concentrate so deeply is linked to a tendency to ignore anything that doesn’t interest them and can become obsessive or compulsive behaviors.  Dystonics have lived in a permanent state of anxiety since they were children, which is why those who seek respite in drugs and alcohol are susceptible to becoming addicts.


The motivation that drives them to fight against everything and everyone to defend their beliefs can make them cognitively rigid, not allowing them to abandon a project or a marriage when clearly it has no future.  Their impulsivity when feeling attacked or misunderstood can make them become aggressive.  Their extreme attention to detail makes it hard for them to pay attention to the larger context, to the total vision, or globality.  Their hyperactivity can make them careless because they want to read or write more rapidly than they really can.  They might skip words or deform their writing to the point of illegibility.  This lack of patience in completing movements is also a lack of patience in accepting the passage of time or in being able to wait for events to move at their own rhythm.  They look for shortcuts, solving problems as fast as they can, making use of their talents and becoming frustrated when they have to wait because they are not able to find a solution.  They can become trapped in a dynamic of instant gratification, a condition they become accustomed to in their youth due to their cognitive and physical abilities.  Sensory stimulus or emotional experiences that would be difficult for other people to assimilate are enormously difficult for them and can take them into states of shock where they cannot react.  Their tendency for cognitive rigidity can make those states become perpetual, providing them no assistance in overcoming their fears.


If rather than being an illness, dystonia is a consequence of a shock in an especially sensitive person, dystonia can be prevented.  If children who have a condition of hypersensitivity were identified and were treated appropriately.  If they were not expected to be something they are not.  If their enormous potential were recognized and developed intellectually and physically.  If they were helped in developing patience and organizational skills, and in recognizing that their weaknesses can make them stronger.  If they were to feel understood and part of a community of equals who would be able to accept them as they do everyone else in society just as they are without trying to change them.  In such a world perhaps it would not be necessary to treat ten million people in shock, who live in a permanent state of suffering, who feel isolated and misunderstood.  Who feel mistreated by a medical system that wants to help them by mutilating their bodies, shocking their brains with magnetism or electricity, anesthetizing their minds with sedatives, invalidating their voices and defining them as dystonics.  Using the name of the disorder to identify them as if the name defines them, separates them from those defined as healthy.  As if that separation actually existed.


If we remove the genes associated with dystonia from our biogical legacy, we would lose forever the possibility of having solo dancers, physics geniuses, elite athletes, writers, painters, musicians, architects, or visionary scientists."


Excerpt from: Limitless. How your movements can heal your brain. An essay on the neurodynamics of dystonia. Joaquin Farias. Galene Edition. 2017





Neuroplasticity-based therapy for dystonia


"The inherent capacity of brain cells to modify themselves and their functions allowing us to learn, change, and adapt is known as brain neuroplasticity.  The modification of neuronal connections makes the repair of cortical and subcortical circuits, the integration of alternative cortical areas in order to carry out modified functions, and recovery from brain injuries possible.

In spite of the fact that the brain is typically thought of as static and unalterable, today we know this is not true. Brain plasticity is possible in adults, although it is more limited than in children.

The different areas of the brain are genetically determined to take part in specific functions; however, in the cerebral cortex in particular, modulation and modification through experience and learning are possible.


Neuroanatomical, neurochemical, and functional changes that occur during plastic reorganization allow for the recovery of affected functions.  In this case, it is known as physiological or adaptive plasticity.  In cases where as a consequence of this reorganization certain functions become more difficult and others are favored, a maladaptive plasticity is produced.

The brain adapts and reorganizes itself to allow functionality though different neuronal mechanisms.  The first mechanism is the creation of new synapses through the sprouting of dendrites, aimed at helping to recover function.  A second option includes the functional reorganization between different neuronal areas or groups within the preexisting neural network.  Redundant circuits exist in the brain which perform similar functions in parallel form.  An injury to one of these pathways makes the other completely take over the transmission of the information and develops pathways that previously existed but were underused or had become inactive.

It is also possible to incorporate new areas to form part of the previously established network, or to use a network that was not usually used for this function and was in charge of completely different functions.  This might imply the learning and use of new strategies.

In other cases, different regions of the brain, which were in charge of carrying out completely different functions, are “recruited” to compensate for losses due to an injury.

Finally, occasionally neighboring or contralateral (another hemisphere) areas provide the function because of a functional reorganization of the cortex, perhaps through the activation of redundant pathways and circuits.

Neurotransmission systems play a very important role as mediators in these processes, since they are involved in the maintenance and cessation of neuronal plasticity, setting the limits for the critical period.

The neurotransmission systems involved in plasticity are:

·      N-Methyl-D-Aspartate System (NMDA), a glutamate receptor that is involved in intracortical facilitation and inhibition mechanisms; It is able to block the capacity for plasticity in the cortex.

·      Cholinergic System (ACh), along with the glutaminergic system, this plays a role in cortical morphogenesis

·      Serotonin System, is involved in the formation and maintenance of new synapses

·      GABAergic System (GABA), the inhibition exerted by the GABA system is overcome by neurochemical changes following an injury in which glutamate is a part, to allow necessary plastic changes required for rapid plasticity recovery.  In the long run, the decrease of GABA-mediated inhibitory tone precedes the unmasking of silent synapses and the consolidation of alternative neighboring or contralateral pathways to preserve or replace the damaged function.  There is evidence that both sensory deprivation and stimulation cause changes in different directions on GABAergic activity.

We could say that the N-Methyl-D-Aspartate System, the Cholinergic System, and the Serotonin System are like fertilizer in a garden, which allows the creation of new connections.  On the other hand, the GABAergic System would be like an anti-fertilizer that preserves what is already acquired.  In this way, balance between creation and preservation in the central nervous system reigns.  In the case of rehabilitation, it is necessary to start the mechanisms of change and establish and stabilize balance."

Excerpt from: Intertwined. How to induce neuroplasticity. A new approach to rehabilitating dystonia. Joaquin Farias. Galen Edition. 2012