Abstract
Background: Recent studies have addressed the role of structures other than the basal ganglia in the pathophysiology of craniocervical dystonia (CCD). Neuroimaging studies have attempted to identify structural abnormalities in CCD but a clear pattern of alteration has not been established. We performed whole-brain evaluation using voxel-based morphometry (VBM) to identify patterns of gray matter (GM) changes in CCD.Methods: We compared 27 patients with CCD matched in age and gender to 54 healthy controls. VBM was used to compare GM volumes. We created a two-sample t-test corrected for subjects’ age, and we tested with a level of significance of p < 0.001 and false discovery rate (FDR) correction (p < 0.05).Results: Voxel-based morphometry demonstrated significant reductions of GM using p < 0.001 in the cerebellar vermis IV/V, bilaterally in the superior frontal gyrus, precuneus, anterior cingulate and paracingulate, insular cortex, lingual gyrus, and calcarine fissure; in the left hemisphere in the supplementary motor area, inferior frontal gyrus, inferior parietal gyrus, temporal pole, supramarginal gyrus, rolandic operculum, hippocampus, middle occipital gyrus, cerebellar lobules IV/V, superior, and middle temporal gyri; in the right hemisphere, the middle cingulate and precentral gyrus. Our study did not report any significant result using the FDR correction. We also detected correlations between GM volume and age, disease duration, duration of botulinum toxin treatment, and the Marsden–Fahn dystonia scale scores.Conclusion: We detected large clusters of GM changes chiefly in structures primarily involved in sensorimotor integration, motor planning, visuospatial function, and emotional processing.
Highlights
Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contractions causing abnormal, often repetitive, postures or movements [1]
Recent studies have addressed the role of structures other than the basal ganglia in the pathophysiology of craniocervical dystonia (CCD)
We detected large clusters of gray matter (GM) changes in structures primarily involved in sensorimotor integration, motor planning, visuospatial function, and emotional processing
Summary
Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contractions causing abnormal, often repetitive, postures or movements [1]. Subjects with different manifestations of CCD probably have underlying differences in brain pathology, clinically there is a significant overlap. Several authors have studied CCD as a group suggesting the presence of common pathological mechanisms [2,3,4,5,6,7]. Considered, a manifestation of basal ganglia dysfunction, neuroimaging techniques have demonstrated structural, functional, and molecular brain abnormalities in areas such as the sensorimotor cortex and cerebellum [2, 7]. Recent studies have addressed the role of structures other than the basal ganglia in the pathophysiology of craniocervical dystonia (CCD). Neuroimaging studies have attempted to identify structural abnormalities in CCD but a clear pattern of alteration has not been established. We performed whole-brain evaluation using voxel-based morphometry (VBM) to identify patterns of gray matter (GM) changes in CCD
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