Abstract
Background: Altered functional connectivity (FC) is related to pathophysiology of patients with cervical dystonia (CD). However, inconsistent results may be obtained due to different selected regions of interest. We explored voxel-wise brain-wide FC changes in patients with CD at rest in an unbiased manner and analyzed their correlations with symptomatic severity using the Tsui scale.Method: A total of 19 patients with CD and 21 sex- and age-matched healthy controls underwent resting-state functional magnetic resonance imaging scans. Global-brain FC (GFC) was applied to analyze the images. Support vector machine was used to distinguish the patients from the controls.Results: Patients with CD exhibited decreased GFC in the right precentral gyrus and right supplementary motor area (SMA) that belonged to the M1-SMA motor network. Significantly negative correlation was observed between GFC values in the right precentral gyrus and symptomatic severity in the patients (r = −0.476, p = 0.039, uncorrected). Decreased GFC values in these two brain regions could be utilized to differentiate the patients from the controls with good accuracies, sensitivities and specificities (83.33, 85.71, and 80.95% in the right precentral gyrus; and 87.59, 89.49, and 85.71% in the right SMA).Conclusions: Our investigation suggests that patients with CD show reduced GFC in brain regions of the M1-SMA motor network and provides further insights into the pathophysiology of CD. GFC values in the right precentral gyrus and right SMA may be used as potential biomarkers to recognize the patients from the controls.
Highlights
Cervical dystonia (CD), known as spasmodic torticollis, is the most common type of focal dystonia with estimated prevalence of 28–183 cases per million individuals [1, 2]
support vector machine (SVM) analysis was conducted to determine whether global-brain FC (GFC) values in these brain areas could distinguish patients with CD from healthy controls with good sensitivity and specificity
Age Sex frame-wise displacement (FD) Illness duration Symptom severity aThe p-value for sex distribution was obtained by a chi-square test. bThe p-values were obtained by two samples t-tests
Summary
Cervical dystonia (CD), known as spasmodic torticollis, is the most common type of focal dystonia with estimated prevalence of 28–183 cases per million individuals [1, 2]. CD is caused by abnormal impulse of central nervous system (CNS) resulting in cervical muscle group paroxysmal involuntary contraction, and presents abnormal posture of head and neck. Simple rotatory torticollis is the most common type occurring in >50% of cases [3]. Patients with CD are often accompanied with neck or shoulder pain and tremor [5, 6]. The chronic neck pain caused by CD leads to disability or low quality of life. Altered functional connectivity (FC) is related to pathophysiology of patients with cervical dystonia (CD). We explored voxel-wise brain-wide FC changes in patients with CD at rest in an unbiased manner and analyzed their correlations with symptomatic severity using the Tsui scale
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