Neurology: Brain functional imaging confirms altered dentate and globus pallidus functional connectivity in patients with focal dystonia, supporting that focal dystonia is a network-specific disease!

Dystonia is a movement disorder that causes involuntary muscle contractions, postural abnormalities, and tremors with variable clinical presentations
.

Among adult-onset focal dystonias, the most common forms are blepharospasm (BSP) and cervical dystonia (CD)

Dystonia is a movement disorder that causes involuntary muscle contractions, postural abnormalities, and tremors with variable clinical presentations

In focal dystonia, neuroimaging studies have reported subtle structural abnormalities in different brain structures that may play a role in the pathophysiology of this disorder

The clinical heterogeneity of focal dystonia suggests that they may have distinct pathophysiological mechanisms

Studying these two types of dystonia using structural and functional imaging techniques is one way to better understand whether CD and BSP have distinct pathophysiological mechanisms

We aimed to investigate structural damage and resting-state functional changes using whole-brain and seed-based approaches in patients with cervical dystonia (CD) and blepharospasm (BSP) to examine Possible functional connectivity (FC) changes are assumed

In this cross-sectional study, multimodal 3T MRI was applied, including 3D T1-weighted images to extract brain volume and cortical thickness, and resting functional MRI to study functional connectivity (FC) of the dentate nucleus and globus pallidus with seed-based map On methods of whole-brain FC
.

In this cross-sectional study, multimodal 3T MRI was applied, including 3D T1-weighted images to extract brain volume and cortical thickness, and resting functional MRI to study functional connectivity (FC) of the dentate nucleus and globus pallidus with seed-based map On methods of whole-brain FC
.

• The study included 33 patients [17 with CD (14 women), age 55.
  7±10.
  1 years, 16 with BSP (11 women), age 62.
  9±8.
  8 years], and 16 age- and sex-matched healthy subjects.
  Subjects (HS) (7 women) were 54.
  3±14.
  3 years old
  .
  
• There were no differences in cortical or subcortical volume between CD patients, BSP patients, and HS
  .
  
• Compared with HS, both CD and BSP patients lost the dentate FC resistance correlation to the sensorimotor cortex
  .
  
• Patients with CD and BSP had increased FC in the cerebellum, supplementary motor areas, and prefrontal cortex compared with HS
  .
  
• Compared with HS, patients with CD had increased dentate FC in the cerebellum and thalamus, and increased FC in the globus pallidus in the bilateral thalamus, sensorimotor and temporo-occipital cortices, and right putamen
  .
  
• Measures of global FC, global efficiency and small-worldness, did not differ between patients and HS
  .
  

The study included 33 patients [17 with CD (14 women), age 55.
7±10.
1 years, 16 with BSP (11 women), age 62.
9±8.
8 years], and 16 age- and sex-matched healthy subjects.
Subjects (HS) (7 women) were 54.
3±14.
3 years old
.

The study included 33 patients [17 with CD (14 women), age 55.
7±10.
1 years, 16 with BSP (11 women), age 62.
9±8.
8 years], and 16 age- and sex-matched healthy subjects.
Subjects (HS) (7 women) were 54.
3±14.
3 years old
.

There were no differences in cortical or subcortical volume between CD patients, BSP patients, and HS

Both CD and BSP patients exhibit dentate and pale-like FC alterations in regions belonging to the cerebellar-basal ganglia-thalamo-cortical sensorimotor circuit, supporting the notion that focal dystonia is a network-specific disease, not just basal Section-altered results, in the context of preserved whole-brain functional architecture

Source: Giannì C, Pasqua G, Ferrazzano G, et al.
Focal Dystonia: Functional Connectivity Changes in Cerebellar-Basal Ganglia-Cortical Circuit and Preserved Global Functional Architecture [published online ahead of print, 2022 Feb 15].
Neurology.
2022; 10.
1212/WNL.
0000000000200022.
doi:10.
1212/WNL.
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