Experimental Brain Research

, Volume 235, Issue 3, pp 949–956 | Cite as

Electromyographic assessment of paratonia

  • Lucio MarinelliEmail author
  • Laura Mori
  • Matteo Pardini
  • David Beversdorf
  • Leonardo Cocito
  • Antonio Currà
  • Francesco Fattapposta
  • Maria Felice Ghilardi
  • Giovanni Abbruzzese
  • Carlo Trompetto
Research Article


Many years after its initial description, paratonia remains a poorly understood concept. It is described as the inability to relax muscles during muscle tone assessment with the subject involuntary facilitating or opposing the examiner. Although related to cognitive impairment and frontal lobe function, the underlying mechanisms have not been clarified. Moreover, criteria to distinguish oppositional paratonia from parkinsonian rigidity or spasticity are not yet available. Paratonia is very frequently encountered in clinical practice and only semi-quantitative rating scales are available. The purpose of this study is to assess the feasibility of a quantitative measure of paratonia using surface electromyography. Paratonia was elicited by performing consecutive metronome-synchronized continuous and discontinuous elbow movements in a group of paratonic patients with cognitive impairment. Goniometric and electromyographic recordings were performed on biceps and triceps brachii muscles. Facilitatory (mitgehen) and oppositional (gegenhalten) paratonia could be recorded on both muscles. After normalization with voluntary maximal contraction, biceps showed higher paratonia than triceps. Facilitatory paratonia was higher than oppositional on the biceps. Movement repetition induced increased paratonic burst amplitude only when flexion and extension movements were performed continuously. Both facilitatory and oppositional paratonia increased with movement repetition. Only oppositional paratonia increased following faster movements. This is the first study providing a quantitative and objective characterization of paratonia using electromyography. Unlike parkinsonian rigidity, oppositional paratonia increases with velocity and with consecutive movement repetition. Like spasticity, oppositional paratonia is velocity-dependent, but different from spasticity, it increases during movement repetition instead of decreasing. A quantitative measure of paratonia could help better understanding its pathophysiology and could be used for research purposes on cognitive impairment.


Paratonia Frontal lobe Electromyography Cognitive impairment Spasticity Movements 



Dr. Beversdorf is the Thompson Center William and Nancy Thompson Endowed Chair in Radiology.

Compliance with ethical standards

Conflict of interest

None of the authors have potential conflicts of interest to be disclosed.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Lucio Marinelli
    • 1
    Email author return OK on get
  • Laura Mori
    • 1
  • Matteo Pardini
    • 1
  • David Beversdorf
    • 2
    • 3
    • 4
    • 5
  • Leonardo Cocito
    • 1
  • Antonio Currà
    • 6
  • Francesco Fattapposta
    • 7
  • Maria Felice Ghilardi
    • 8
  • Giovanni Abbruzzese
    • 1
  • Carlo Trompetto
    • 1
  1. 1.Institute of Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenovaGenoaItaly
  2. 2.Department of RadiologyUniversity of MissouriColumbiaUSA
  3. 3.Department of NeurologyUniversity of MissouriColumbiaUSA
  4. 4.Department of Psychological SciencesUniversity of MissouriColumbiaUSA
  5. 5.The Thompson Center for Neurodevelopmental DisordersUniversity of MissouriColumbiaUSA
  6. 6.Academic Neurology Unit, A. Fiorini Hospital, Terracina (LT), Department of Medical-Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
  7. 7.Neurology Unit, Policlinico Umberto I, Department of Neurology and PsichiatrySapienza University of RomeRomeItaly
  8. 8.Department of Physiology, Pharmacology and NeuroscienceCity University of New York Medical SchoolNew YorkUSA

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