Structural brain abnormalities in cervical dystonia

Abstract

BackgroundIdiopathic cervical dystonia is characterized by involuntary spasms, tremors or jerks. It is not restricted to a disturbance in the basal ganglia system because non-conventional voxel-based MRI morphometry (VBM) and diffusion tensor imaging (DTI) have detected numerous regional changes in the brains of patients.In this study scans of 24 patients with cervical dystonia and 24 age-and sex-matched controls were analysed using VBM, DTI and magnetization transfer imaging (MTI) using a voxel-based approach and a region-of-interest analysis. Results were correlated with UDRS, TWSTRS and disease duration.ResultsWe found structural alterations in the basal ganglia; thalamus; motor cortex; premotor cortex; frontal, temporal and parietal cortices; visual system; cerebellum and brainstem of the patients with dystonia.ConclusionsCervical dystonia is a multisystem disease involving several networks such as the motor, sensory and visual systems.

Dynamic cortical gray matter volume changes after botulinum toxin in cervical dystonia

“…Our cross-sectional observations are partially in agreement with earlier, smaller sized studies concerning VBM in CD that also demonstrated decreased GMV in higher order motor areas, specifically the prefrontal cortex, premotor cortex, and supplementary motor area (Draganski et al, 2003;Pantano et al, 2011;Prell et al, 2013). By contrast, we did not find GMV alterations in the basal ganglia, the cerebellum, or the primary sensorimotor cortex (Draganski et al, 2003;Pantano et al, 2011;Granert et al, 2011).…”

“…More specifically, imaging parameters and scanner characteristics influence GM segmentation. Also, the use of newer VBM analysis procedures (see Methods section) and the application of particular statistical methods (correction for non-stationarity of structural images and the use of whole-brain analysis without predefined cortical anatomical regions of interest or masks) may provide an explanation for the discrepancies with these previous, but recent studies (Draganski et al, 2003;Pantano et al, 2011;Prell et al, 2013). Alternatively, differences in population size, age, and disease duration or severity are important for GMV differences.…”

“…Studies using voxel-based morphometry (VBM) reported alterations in gray matter (GM) volume in the basal ganglia (Draganski et al, 2003;Pantano et al, 2011;Prell et al, 2013), the cortical motor circuitry (Draganski et al, 2003;Pantano et al, 2011;Prell et al, 2013), and the cerebellum in CD (Draganski et al, 2003;Prell et al, 2013). Despite several reports on structural differences between dystonia patients and healthy controls at baseline, few studies exist on longitudinal structural changes.…”

A Functional Magnetic Resonance Imaging Study of Head Movements in Cervical Dystonia

“…Clinical imaging studies using computed tomography and structural MRI have linked CD with focal lesions of cerebellar circuits (14, 47, 50, 51). A diffusion tensor imaging (DTI) study in individuals with craniocervical dystonia (dystonia of facial and neck muscles combined) indicated abnormal cerebellar microstructure and fiber organization, especially in the anterior cerebellum and vermis (52). Another DTI study showed that persons with CD had decreased axonal fiber organization in the superior cerebellar peduncles, which carry the output fibers from the cerebellum to the thalamus and brainstem (53).…”

“…Another DTI study showed that persons with CD had decreased axonal fiber organization in the superior cerebellar peduncles, which carry the output fibers from the cerebellum to the thalamus and brainstem (53). Voxel-based morphometry studies in CD have demonstrated abnormalities in cerebellar gray matter volume, including the anterior cerebellum (15, 17, 52, 54, 55). PET studies have indicated increased glucose metabolism in the cerebellar hemispheres bilaterally (22).…”