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Conte A, Defazio G, Mascia M, Belvisi D, Pantano P, Berardelli A. Advances in the pathophysiology of adult-onset focal dystonias: recent neurophysiological and neuroimaging evidence. F1000Res 2020; 9. [PMID: 32047617 PMCID: PMC6993830 DOI: 10.12688/f1000research.21029.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 12/28/2022] Open
Abstract
Focal dystonia is a movement disorder characterized by involuntary muscle contractions that determine abnormal postures. The traditional hypothesis that the pathophysiology of focal dystonia entails a single structural dysfunction (i.e. basal ganglia) has recently come under scrutiny. The proposed network disorder model implies that focal dystonias arise from aberrant communication between various brain areas. Based on findings from animal studies, the role of the cerebellum has attracted increased interest in the last few years. Moreover, it has been increasingly reported that focal dystonias also include nonmotor disturbances, including sensory processing abnormalities, which have begun to attract attention. Current evidence from neurophysiological and neuroimaging investigations suggests that cerebellar involvement in the network and mechanisms underlying sensory abnormalities may have a role in determining the clinical heterogeneity of focal dystonias.
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Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy
| | - Marcello Mascia
- Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy
| | | | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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Mantel T, Meindl T, Li Y, Jochim A, Gora-Stahlberg G, Kräenbring J, Berndt M, Dresel C, Haslinger B. Network-specific resting-state connectivity changes in the premotor-parietal axis in writer's cramp. NEUROIMAGE-CLINICAL 2017; 17:137-144. [PMID: 29085775 PMCID: PMC5650679 DOI: 10.1016/j.nicl.2017.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/12/2017] [Accepted: 10/02/2017] [Indexed: 12/03/2022]
Abstract
Background Writer's cramp is a task-specific dystonia impairing writing and sometimes other fine motor tasks. Neuroimaging studies using manifold designs have shown varying results regarding the nature of changes in the disease. Objective To clarify and extend the knowledge of underlying changes by investigating functional connectivity (FC) in intrinsic connectivity networks with putative sensorimotor function at rest in an increased number of study subjects. Methods Resting-state functional magnetic resonance imaging with independent component analysis was performed in 26/27 writer's cramp patients/healthy controls, and FC within and between resting state networks with putative sensorimotor function was compared. Additionally, voxel-based morphometry was carried out on the subjects' structural images. Results Patients displayed increased left- and reduced right-hemispheric primary sensorimotor FC in the premotor-parietal network. Mostly bilaterally altered dorsal/ventral premotor FC, as well as altered parietal FC were observed within multiple sensorimotor networks and showed differing network-dependent directionality. Beyond within-network FC changes and reduced right cerebellar grey matter volume in the structural analysis, the positive between-network FC of the cerebellar network and the basal ganglia network was reduced. Conclusions Abnormal resting-state FC in multiple networks with putative sensorimotor function may act as basis of preexisting observations made during task-related neuroimaging. Further, altered connectivity between the cerebellar and basal ganglia network underlines the important role of these structures in the disease. Investigation of FC changes in various sensorimotor ICNs at rest in writer's cramp. We saw multiple, network-specific FC changes in primary/higher sensorimotor cortices. This may act as basis of the varying nature of sensorimotor changes during task-fMRI. Further, findings supporting disrupted cerebellar-basal ganglia interaction were made. An additional morphometric analysis demonstrated structural cerebellar abnormality.
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Key Words
- ADDS, arm dystonia disability scale
- BGN, basal ganglia network
- BOLD, blood oxygen level-dependent
- CN, cerebellar network
- CONTR, healthy controls
- Cerebellum
- Dystonia
- FC, functional connectivity
- FHD, focal hand dystonia
- FWHM, full width at half maximum
- FoV, field of view
- Functional connectivity
- GM, grey matter
- IC, independent component
- ICA, independent component analysis
- ICN, intrinsic connectivity network
- IPS, intraparietal sulcus
- M1, primary motor cortex
- PAT, writer's cramp patients
- PCA, principal component analysis
- PMd/v, dorsal/ventral premotor cortex
- PPN, premotor parietal network
- Premotor cortex
- ROI, region of interest
- Resting state
- S1, primary somatosensory cortex
- S2, secondary somatosensory cortex
- SM1, primary sensorimotor cortex
- SMA, supplementary motor area
- SMG, supramarginal gyrus
- SPC, superior parietal cortex
- TIV, total intracranial volume
- WC, writer's cramp
- WCRS, writer's cramp rating scale
- rsfMRI, resting state functional magnetic resonance imaging
- v/dSMN, ventral/dorsal sensorimotor network
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Affiliation(s)
- Tobias Mantel
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Tobias Meindl
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Yong Li
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Angela Jochim
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Gina Gora-Stahlberg
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Jona Kräenbring
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany; Department of Psychiatry, Isar-Amper-Klinikum München-Ost, Vockestrasse 72, Haar, Germany
| | - Maria Berndt
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Christian Dresel
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany; Department of Neurology, Johannes Gutenberg University, School of Medicine, Langenbeckstrasse 1, Mainz, Germany
| | - Bernhard Haslinger
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany.
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