1
|
Huang MH, Lang J, Li J, Qin Z, Cao YP. Characteristics of brain activation in high-level football players at different stages of decision-making tasks off the ball: an fMRI study. Front Hum Neurosci 2023; 17:1189841. [PMID: 37701501 PMCID: PMC10494545 DOI: 10.3389/fnhum.2023.1189841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/18/2023] [Indexed: 09/14/2023] Open
Abstract
Objective This study aimed to examine the neural mechanisms underlying the decision-making process of off-ball movements among high-level football players and ordinary college students, as well as the effect of long-term skill training on these neural mechanisms using functional magnetic resonance imaging (fMRI). Methods The study recruited 20 professional college football players as the expert group (EG) and 20 novice football players with no background in sports-related disciplines as the novice group (NG). The participants performed the motor video observation and button-decision-making tasks, and fMRI data were acquired, pre-processed, and analyzed. Results During the decision-making process regarding running without the ball, whole-brain fMRI scans were conducted on both the EG and NG. The analysis of these scans revealed noteworthy disparities in brain activity between the two groups. These disparities were observed during tasks involving motor video observation and button-based decision-making. According to the behavioral data, the EG made more correct decisions than the NG (p < 0.05); however, there was no significant difference in their reaction speed (p > 0.05). During video observation, both the EG and NG exhibited simultaneous activation in the frontoparietal cognitive area, primary somatosensory cortex, visual cortex, and insula. However, there were no significant differences between the two groups in terms of activated brain regions [false discovery rate (FDR) corrected to p < 0.05]. Regarding button-press decisions, the areas of the brain that were commonly activated in both the NG and EG were primarily located in the frontoparietal cognitive area, temporal cortex, and cuneus cortex. Notably, the left superior temporal gyrus, left inferior temporal gyrus, and left middle occipital gyrus exhibited greater activation in the NG compared to those in the EG (FDR corrected to p < 0.05). Conclusion This study demonstrated that during motor video observation, the EG's sports experience and professional knowledge can help them achieve better visual information processing strategies in specific areas of sports. During button decision-making, the EG was more economical, whereas the NG required more brain function activity to process visual information, confirming the "neural efficiency" hypothesis.
Collapse
Affiliation(s)
- Ming-Hao Huang
- School of Physical Education and Sports, Beijing Normal University, Beijing, China
- Collage of Physical Education, Northwest Normal University, Lanzhou, China
| | - Jian Lang
- School of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Ju Li
- School of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Zhe Qin
- School of Physical Education and Sports, Beijing Normal University, Beijing, China
- Collage of Physical Education, Northwest Normal University, Lanzhou, China
| | - Ya-Ping Cao
- School of Physical Education and Sports, Beijing Normal University, Beijing, China
| |
Collapse
|
2
|
Wu Y, Zhang C, Li Y, Feng J, Zhang M, Li H, Wang T, Zhang Y, Jin Z, Zhang C, Zhang Y, Li D, Wu Y, Wei H, Sun B. Imaging Insights of Isolated Idiopathic Dystonia: Voxel-Based Morphometry and Activation Likelihood Estimation Studies. Front Neurol 2022; 13:823882. [PMID: 35557619 PMCID: PMC9087834 DOI: 10.3389/fneur.2022.823882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
The understanding of brain structural abnormalities across different clinical forms of dystonia and their contribution to clinical characteristics remains unclear. The objective of this study is to investigate shared and specific gray matter volume (GMV) abnormalities in various forms of isolated idiopathic dystonia. We collected imaging data from 73 isolated idiopathic dystonia patients and matched them with healthy controls to explore the GMV alterations in patients and their correlations with clinical characteristics using the voxel-based morphometry (VBM) technique. In addition, we conducted an activation likelihood estimation (ALE) meta-analysis of previous VBM studies. Our study demonstrated widespread morphometry alterations in patients with idiopathic dystonia. Multiple systems were affected, which mainly included basal ganglia, sensorimotor, executive control, and visual networks. As the result of the ALE meta-analysis, a convergent cluster with increased GMV was found in the left globus pallidus. In subgroup VBM analyses, decreased putamen GMV was observed in all clinic forms, while the increased GMV was observed in parahippocampal, lingual, and temporal gyrus. GD demonstrated the most extensive GMV abnormalities in cortical regions, and the aberrant GMV of the posterior cerebellar lobe was prominent in CD. Moreover, trends of increased GMV regions of the left precuneus and right superior frontal gyrus were demonstrated in the moderate-outcome group compared with the superior-outcome group. Results of our study indicated shared pathophysiology of the disease-centered on the dysfunction of the basal ganglia-thalamo-cortical circuit, impairing sensorimotor integration, high-level motor execution, and cognition of patients. Dysfunction of the cerebello-thalamo-cortical circuit could also be involved in CD especially. Finally, the frontal-parietal pathway may act as a potential marker for predicting treatment outcomes such as deep brain stimulation.
Collapse
Affiliation(s)
- Yunhao Wu
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufei Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Feng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ming Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Hongxia Li
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijia Jin
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyao Zhang
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwen Wu
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongjiang Wei
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Hongjiang Wei
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Bomin Sun
| |
Collapse
|
3
|
Wang X, Hu W, Wang H, Gao D, Liu Y, Zhang X, Jiang Y, Mo J, Meng F, Zhang K, Zhang JG. Altered Structural Brain Network Topology in Patients With Primary Craniocervical Dystonia. Front Neurol 2022; 13:763305. [PMID: 35432176 PMCID: PMC9005792 DOI: 10.3389/fneur.2022.763305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeRegional cortical thickness or volume analyses based upon structural MRI scans have been employed to study the pathophysiology of primary craniocervical dystonia (CCD). In the present study, brain connectivity network analyses based upon morphological distribution similarities among different brain areas were used to study the network disruption in individuals affected by CCD.MethodsThe T1 MRI scans were completed for 37 patients with CCD and 30 healthy controls, with individual brain structural networks being constructed based upon gray matter (GM) similarities in 90 regions within the brain. Area under the curve (AUC) values for each network parameter were determined, and the GRETNA program was used to conduct a graph theory-based measurement of nodal and global network properties. These properties were then compared between healthy controls and those with CCD. In addition, relationships between nodal properties and the severity of clinical dystonia were assessed through Spearman's correlation analyses.ResultsRelative to individuals in the control group, patients with CCD exhibited decreased local nodal properties in the right globus pallidus, right middle frontal gyrus, and right superior temporal pole. The degree of centrality as well as the node efficiency of the right globus pallidus were found to be significantly correlated with ocular dystonic symptom. The node efficiency of right middle frontal gyrus was significantly related to the total motor severity. No nodal properties were significantly correlated with oral dystonic motor scores. Among CCD patients, the right hemisphere exhibited more widespread decreases in connectivity associated with the motor related brain areas, associative cortex, and limbic system, particularly in the middle frontal gyrus, globus pallidus, and cingulate gyrus.ConclusionsThe assessment of morphological correlations between different areas in the brain may represent a sensitive approach for detecting alterations in brain structures and to understand the mechanistic basis for CCD at the network level. Based on the nodal properties identified in this study, the right middle frontal gyrus and globus pallidus were the most severely affected in patients with CCD. The widespread alterations in morphological connectivity, such as the cortico-cortical and cortico-subcortical networks, further support the network mechanism as a basis for CCD.
Collapse
Affiliation(s)
- Xiu Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Wenhan Hu
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Huimin Wang
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Department of Functional Neurosurgery, Medical Alliance of Beijing Tian Tan Hospital, Peking University First Hospital Fengtai Hospital, Beijing, China
| | - Dongmei Gao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yuye Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Xin Zhang
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yin Jiang
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jiajie Mo
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Fangang Meng
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Kai Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Kai Zhang
| | - Jian-guo Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
- Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- *Correspondence: Jian-guo Zhang
| |
Collapse
|
4
|
Huang X, Lin J, Shang H, Yang J. Voxel-based meta-analysis of gray matter abnormalities in idiopathic dystonia. J Neurol 2022; 269:2862-2873. [PMID: 35013788 DOI: 10.1007/s00415-022-10961-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neuroimaging studies have reported gray matter changes in patients with idiopathic dystonia but with considerable variations. Here, we aimed to investigate the convergence of dystonia-related gray matter changes across studies. METHODS The whole brain voxel-based morphometry studies comparing idiopathic dystonia and healthy controls were systematically searched in the PubMed, Web of Science and Embase. Meta-analysis of gray matter changes was performed using the anisotropic effect size-based signed differential mapping. RESULTS Twenty-eight studies comparing 701 idiopathic dystonia patients and 712 healthy controls were included in the meta-analysis. Compared to healthy controls, idiopathic dystonia patients showed increased gray matter in bilateral precentral and postcentral gyri, bilateral putamen and pallidum, right insula, and left supramarginal gyrus, while decreased gray matter in bilateral temporal poles, bilateral supplementary motor areas, right angular gyrus, inferior parietal gyrus and precuneus, left insula and inferior frontal gyrus. These findings remained robust in the jackknife sensitivity analysis, and no significant heterogeneity was detected. Subgroup analyses of different phenotypes of dystonia were performed to further confirm the above findings. CONCLUSION The meta-analysis showed that consistent widespread gray matter abnormalities were shared in different subtypes of idiopathic dystonia and were not restricted to the corticostriatal circuits.
Collapse
Affiliation(s)
- Xiang Huang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junyu Lin
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
5
|
Liu J, Li L, Li Y, Wang Q, Liu R, Ding H. Regional metabolic and network changes in Meige syndrome. Sci Rep 2021; 11:15753. [PMID: 34344985 PMCID: PMC8333318 DOI: 10.1038/s41598-021-95333-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 07/26/2021] [Indexed: 11/15/2022] Open
Abstract
To contribute to the understanding of the aetiology and pathogenesis of Meige syndrome, the metabolic networks of patients with Meige syndrome were investigated using 18F-fluoro-D-glucose positron emission tomography (18F-FDG-PET) imaging of cerebral glucose metabolism. Fifty right-handed and unmedicated primary Meige syndrome patients enrolled between September 2017 and September 2020 at the Department of Neurosurgery, Peking University People’s Hospital, and 50 age- and sex-matched healthy control subjects participated in the study. Metabolic connectivity and graph theory analysis were used to investigate metabolic network differences based on 18F-FDG-PET images. Glucose hypometabolism was detected in the left internal globus pallidus and parietal lobe, right frontal lobe and postcentral gyrus, and bilateral thalamus and cerebellum of patients with Meige syndrome. Clustering coefficients (Cps) (density threshold: 16–28%; P < 0.05) and shortest path lengths (Lps) (density threshold: 10–15%; P < 0.05) were higher in Meige syndrome patients than in healthy controls. Small-worldness was lower in Meige syndrome patients than in healthy controls, and centrality was significantly lower in the right superior occipital gyrus and pallidum and higher in the right thalamus. Hypometabolism in the globus pallidus and thalamus may indicate basal ganglia-thalamocortical motor circuit abnormalities as a pathogenic mechanism of Meige syndrome, providing a possible explanation for the efficacy of deep brain stimulation (DBS) in improving symptoms. Meige syndrome patients had abnormal small-world properties. Centrality changes in the right pallidus and thalamus verified the important roles of these regions in the pathogenesis of Meige syndrome.
Collapse
Affiliation(s)
- Jiayu Liu
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St, Beijing, 100044, China
| | - Lei Li
- Department of Nuclear Medicine, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), No. 79 Kangning Road, Xiangzhou District, Zhuhai, 519000, Guangdong, China
| | - Yuan Li
- Department of Nuclear Medicine, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Qian Wang
- Department of Nuclear Medicine, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Ruen Liu
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St, Beijing, 100044, China.
| | - Hu Ding
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St, Beijing, 100044, China
| |
Collapse
|
6
|
Bai X, Vajkoczy P, Faust K. Morphological Abnormalities in the Basal Ganglia of Dystonia Patients. Stereotact Funct Neurosurg 2021; 99:351-362. [PMID: 33472209 DOI: 10.1159/000512599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/23/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The pathophysiology of dystonia is poorly understood. As opposed to secondary forms of dystonia, primary dystonia has long been believed to lack any neuroanatomical substrate. During trajectory planning for DBS, however, conspicuous T2-hyperinstensive signal alterations (SA) were registered within the target region, even in young patients, where ischemia is rare. METHODS Fifty MRIs of primary dystonia patients scheduled for DBS were analyzed. Total basal ganglia (BG) volumes, as well as proportionate SA volumes, were measured and compared to 50 age-matched control patients. RESULTS There was a 10-fold preponderance of percentaged SA within the globus pallidus (GP) in dystonia patients. The greatest disparity was in young patients <25 years. Also, total BG volume differences were observed with larger GP and markedly smaller putamen and caudate in the dystonia group. CONCLUSIONS BG morphology in primary dystonia differed from a control population. Volume reductions of the putamen and caudate may reflect functional degeneration, while volume increases of the GP may indicate overactivity. T2-hyperintensive SA in the GP of young primary dystonia patients, where microvascular lesions are highly unlikely, are striking. Their pathogenic role remains unclear.
Collapse
Affiliation(s)
- Xi Bai
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany
| | - Katharina Faust
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany,
| |
Collapse
|
7
|
Liu J, Li L, Chen L, Liu R, Jiang Y, Fang J, Wang D, Liu Z, Ouyang J. Grey matter changes in Meige syndrome: a voxel-based morphology analysis. Sci Rep 2020; 10:14533. [PMID: 32884000 PMCID: PMC7471903 DOI: 10.1038/s41598-020-71479-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/13/2020] [Indexed: 11/19/2022] Open
Abstract
To investigate the changes and clinical significance of brain structural abnormalities in patients with Meige syndrome and related depressive symptoms. We retrospectively analysed clinical data, imaging examinations, and Hamilton Depression Rating scale scores in 46 patients with Meige syndrome from January 2017 to January 2019. We compared the Meige syndrome group with the healthy control group, and the definite depression group with the non-definite depression group. Voxel-based morphometry (VBM) was used to compare grey matter (GM) volumes. We conducted two-sample t-tests corrected for subject age and gender. We tested at a level of significance of p < 0.001 with a false discovery rate (FDR) correction. VBM demonstrated decreased GM volume (p < 0.001 and cluster size > 50 voxels) in the left hemisphere in the middle frontal orbital gyrus, temporal pole (superior temporal gyrus) and insula and in the right hemisphere in the temporal pole (middle temporal gyrus), precuneus, inferior parietal, inferior temporal and olfactory cortices in the Meige syndrome group. Comparing VBM-MRI measures in Meige syndrome patients with and without depression, decreased GM volume was found in the left hemisphere in the cuneus and hippocampus and in the right hemisphere in the angular gyrus, middle frontal gyrus and middle occipital gyrus in the definite depression group. Unlike other dystonia studies that have suggested an involvement of the basal ganglia and motor cortex in the pathophysiology of the disorder , we believe that the precuneus is involved in the development of Meige syndrome. Additionally, our findings suggest that the hippocampus plays a role in the pathogenesis of depression in patients with Meige syndrome.
Collapse
Affiliation(s)
- Jiayu Liu
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Lei Li
- Department of Nuclear Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), No. 79 Kangning Road, Xiangzhou District, Zhuhai, 519000, Guangdong, China
| | - Lei Chen
- Department of Radiology, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Ruen Liu
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China. .,Department of Neurosurgery Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, Jiangxi, China.
| | - Yongan Jiang
- Department of Neurosurgery Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jixia Fang
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Dongliang Wang
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Zhi Liu
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| | - Jia Ouyang
- Department of Neurosurgery, Peking University People's Hospital, 11th Xizhimen South St., Beijing, 100044, China
| |
Collapse
|
8
|
Perturbed Ca2+-dependent signaling of DYT2 hippocalcin mutant as mechanism of autosomal recessive dystonia. Neurobiol Dis 2019; 132:104529. [DOI: 10.1016/j.nbd.2019.104529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/22/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
|
9
|
Gracien RM, Petrov F, Hok P, van Wijnen A, Maiworm M, Seiler A, Deichmann R, Baudrexel S. Multimodal Quantitative MRI Reveals No Evidence for Tissue Pathology in Idiopathic Cervical Dystonia. Front Neurol 2019; 10:914. [PMID: 31507518 PMCID: PMC6719627 DOI: 10.3389/fneur.2019.00914] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/06/2019] [Indexed: 01/02/2023] Open
Abstract
Background: While in symptomatic forms of dystonia cerebral pathology is by definition present, it is unclear so far whether disease is associated with microstructural cerebral changes in idiopathic dystonia. Previous quantitative MRI (qMRI) studies assessing cerebral tissue composition in idiopathic dystonia revealed conflicting results. Objective: Using multimodal qMRI, the presented study aimed to investigate alterations in different cerebral microstructural compartments associated with idiopathic cervical dystonia in vivo. Methods: Mapping of T1, T2, T2*, and proton density (PD) was performed in 17 patients with idiopathic cervical dystonia and 29 matched healthy control subjects. Statistical comparisons of the parametric maps between groups were conducted for various regions of interest (ROI), including major basal ganglia nuclei, the thalamus, white matter, and the cerebellum, and voxel-wise for the whole brain. Results: Neither whole brain voxel-wise statistics nor ROI-based analyses revealed significant group differences for any qMRI parameter under investigation. Conclusions: The negative findings of this qMRI study argue against the presence of overt microstructural tissue change in patients with idiopathic cervical dystonia. The results seem to support a common view that idiopathic cervical dystonia might primarily resemble a functional network disease.
Collapse
Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Franca Petrov
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Pavel Hok
- Department of Neurology, Goethe University, Frankfurt, Germany.,Department of Neurology, Palacký University Olomouc and University Hospital Olomouc, Olomouc, Czechia
| | - Alexandra van Wijnen
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| |
Collapse
|
10
|
Alterations of Interhemispheric Functional Connectivity and Degree Centrality in Cervical Dystonia: A Resting-State fMRI Study. Neural Plast 2019; 2019:7349894. [PMID: 31178903 PMCID: PMC6507243 DOI: 10.1155/2019/7349894] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/19/2019] [Accepted: 03/21/2019] [Indexed: 12/17/2022] Open
Abstract
Background Cervical dystonia (CD) is a neurological movement disorder characterized by involuntary head and neck movements and postures. Reports on microstructural and functional abnormalities in multiple brain regions not limited to the basal ganglia have been increasing in patients with CD. However, the neural bases of CD are unclear. This study is aimed at identifying cerebral functional abnormalities in CD by using resting-state functional magnetic resonance imaging (rs-fMRI). Methods Using rs-fMRI data, voxel-mirrored homotopic connectivity (VMHC) and degree centrality were used to compare the alterations of the rs-functional connectivity (FC) between 19 patients with CD and 21 healthy controls. Regions showing abnormal FCs from two measurements were the regions of interest for correlation analyses. Results Compared with healthy controls, patients with CD exhibited significantly decreased VMHC in the supplementary motor area (SMA), precuneus (PCu)/postcentral gyrus, and superior medial prefrontal cortex (MPFC). Significantly increased degree centrality in the right PCu and decreased degree centrality in the right lentiform nucleus and left ventral MPFC were observed in the patient group compared with the control group. Further correlation analyses showed that the VMHC values in the SMA were negatively correlated with dystonia severity. Conclusion Local abnormalities and interhemispheric interaction deficits in the sensorimotor network (SMA, postcentral gyrus, and PCu), default mode network (MPFC and PCu), and basal ganglia may be the key characteristics in the pathogenesis mechanism of CD.
Collapse
|
11
|
Odorfer TM, Homola GA, Reich MM, Volkmann J, Zeller D. Increased Finger-Tapping Related Cerebellar Activation in Cervical Dystonia, Enhanced by Transcranial Stimulation: An Indicator of Compensation? Front Neurol 2019; 10:231. [PMID: 30930842 PMCID: PMC6428698 DOI: 10.3389/fneur.2019.00231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Cervical dystonia is a movement disorder causing abnormal postures and movements of the head. While the exact pathophysiology of cervical dystonia has not yet been fully elucidated, a growing body of evidence points to the cerebellum as an important node. Methods: Here, we examined the impact of cerebellar interference by transcranial magnetic stimulation on finger-tapping related brain activation and neurophysiological measures of cortical excitability and inhibition in cervical dystonia and controls. Bilateral continuous theta-burst stimulation was used to modulate cerebellar cortical excitability in 16 patients and matched healthy controls. In a functional magnetic resonance imaging arm, data were acquired during simple finger tapping before and after cerebellar stimulation. In a neurophysiological arm, assessment comprised motor-evoked potentials amplitude and cortical silent period duration. Theta-burst stimulation over the dorsal premotor cortex and sham stimulation (neurophysiological arm only) served as control conditions. Results: At baseline, finger tapping was associated with increased activation in the ipsilateral cerebellum in patients compared to controls. Following cerebellar theta-burst stimulation, this pattern was even more pronounced, along with an additional movement-related activation in the contralateral somatosensory region and angular gyrus. Baseline motor-evoked potential amplitudes were higher and cortical silent period duration shorter in patients compared to controls. After cerebellar theta-burst stimulation, cortical silent period duration increased significantly in dystonia patients. Conclusion: We conclude that in cervical dystonia, finger movements—though clinically non-dystonic—are associated with increased activation of the lateral cerebellum, possibly pointing to general motor disorganization, which remains subclinical in most body regions. Enhancement of this activation together with an increase of silent period duration by cerebellar continuous theta-burst stimulation may indicate predominant disinhibitory effects on Purkinje cells, eventually resulting in an inhibition of cerebello-thalamocortical circuits.
Collapse
Affiliation(s)
| | - György A Homola
- Department of Neuroradiology, University of Würzburg, Würzburg, Germany
| | - Martin M Reich
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, Würzburg, Germany
| |
Collapse
|
12
|
Central Effects of Botulinum Neurotoxin-Evidence from Human Studies. Toxins (Basel) 2019; 11:toxins11010021. [PMID: 30621330 PMCID: PMC6356587 DOI: 10.3390/toxins11010021] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/25/2018] [Accepted: 12/31/2018] [Indexed: 11/24/2022] Open
Abstract
For more than three decades, Botulinum neurotoxin (BoNT) has been used to treat a variety of clinical conditions such as spastic or dystonic disorders by inducing a temporary paralysis of the injected muscle as the desired clinical effect. BoNT is known to primarily act at the neuromuscular junction resulting in a biochemical denervation of the treated muscle. However, recent evidence suggests that BoNT’s pharmacological properties may not only be limited to local muscular denervation at the injection site but may also include additional central effects. In this review, we report and discuss the current evidence for BoNT’s central effects based on clinical observations, neurophysiological investigations and neuroimaging studies in humans. Collectively, these data strongly point to indirect mechanisms via changes to sensory afferents that may be primarily responsible for the marked plastic effects of BoNT on the central nervous system. Importantly, BoNT-related central effects and consecutive modulation and/or reorganization of the brain may not solely be considered “side-effects” but rather an additional therapeutic impact responsible for a number of clinical observations that cannot be explained by merely peripheral actions.
Collapse
|
13
|
Berman BD, Pollard RT, Shelton E, Karki R, Smith-Jones PM, Miao Y. GABA A Receptor Availability Changes Underlie Symptoms in Isolated Cervical Dystonia. Front Neurol 2018; 9:188. [PMID: 29670567 PMCID: PMC5893646 DOI: 10.3389/fneur.2018.00188] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/12/2018] [Indexed: 11/28/2022] Open
Abstract
GABAA receptor availability changes within sensorimotor regions have been reported in some isolated forms of dystonia. Whether similar abnormalities underlie symptoms in cervical dystonia is not known. In the present study, a total of 15 cervical dystonia patients and 15 age- and sex-matched controls underwent 11C-flumazenil PET/CT scanning. The density of available GABAA receptors was estimated using a Simplified Reference Tissue Model 2. Group differences were evaluated using a two-sample T-test, and correlations with dystonia severity, as measured by the Toronto Western Spasmodic Torticollis Rating Scale, and disease duration were evaluated using a regression analysis. Voxel-based analyses revealed increased GABAA availability within the right precentral gyrus in brain motor regions previously associated with head turning and the left parahippocampal gyrus. GABAA availability within the bilateral cerebellum was negatively correlated with dystonia severity, and GABAA availability within the right thalamus and a variety of cerebellar and cortical regions were negatively correlated with disease duration. While GABAA availability changes within primary motor areas could represent a partial compensatory response to loss of inhibition within sensorimotor network, GABAergic signaling impairment within the cerebellum may be a key contributor to dystonia severity.
Collapse
Affiliation(s)
- Brian D Berman
- Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Neurology Section, Denver VA Medical Center, Denver, CO, United States
| | - Rebecca Tran Pollard
- Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Erika Shelton
- Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ramesh Karki
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Peter M Smith-Jones
- Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Yubin Miao
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| |
Collapse
|
14
|
Battistella G, Termsarasab P, Ramdhani RA, Fuertinger S, Simonyan K. Isolated Focal Dystonia as a Disorder of Large-Scale Functional Networks. Cereb Cortex 2018; 27:1203-1215. [PMID: 26679193 DOI: 10.1093/cercor/bhv313] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Isolated focal dystonias are a group of disorders with diverse symptomatology but unknown pathophysiology. Although recent neuroimaging studies demonstrated regional changes in brain connectivity, it remains unclear whether focal dystonia may be considered a disorder of abnormal networks. We examined topology as well as the global and local features of large-scale functional brain networks across different forms of isolated focal dystonia, including patients with task-specific (TSD) and nontask-specific (NTSD) dystonias. Compared with healthy participants, all patients showed altered network architecture characterized by abnormal expansion or shrinkage of neural communities, such as breakdown of basal ganglia-cerebellar community, loss of a pivotal region of information transfer (hub) in the premotor cortex, and pronounced connectivity reduction within the sensorimotor and frontoparietal regions. TSD were further characterized by significant connectivity changes in the primary sensorimotor and inferior parietal cortices and abnormal hub formation in insula and superior temporal cortex, whereas NTSD exhibited abnormal strength and number of regional connections. We suggest that isolated focal dystonias likely represent a disorder of large-scale functional networks, where abnormal regional interactions contribute to network-wide functional alterations and may underline the pathophysiology of isolated focal dystonia. Distinct symptomatology in TSD and NTSD may be linked to disorder-specific network aberrations.
Collapse
Affiliation(s)
| | | | | | | | - Kristina Simonyan
- Department of Neurology.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
15
|
Jinnah HA, Neychev V, Hess EJ. The Anatomical Basis for Dystonia: The Motor Network Model. Tremor Other Hyperkinet Mov (N Y) 2017; 7:506. [PMID: 29123945 PMCID: PMC5673689 DOI: 10.7916/d8v69x3s] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 09/25/2017] [Indexed: 01/27/2023] Open
Abstract
Background The dystonias include a clinically and etiologically very diverse group of disorders. There are both degenerative and non-degenerative subtypes resulting from genetic or acquired causes. Traditionally, all dystonias have been viewed as disorders of the basal ganglia. However, there has been increasing appreciation for involvement of other brain regions including the cerebellum, thalamus, midbrain, and cortex. Much of the early evidence for these other brain regions has come from studies of animals, but multiple recent studies have been done with humans, in an effort to confirm or refute involvement of these other regions. The purpose of this article is to review the new evidence from animals and humans regarding the motor network model, and to address the issues important to translational neuroscience. Methods The English literature was reviewed for articles relating to the neuroanatomical basis for various types of dystonia in both animals and humans. Results There is evidence from both animals and humans that multiple brain regions play an important role in various types of dystonia. The most direct evidence for specific brain regions comes from animal studies using pharmacological, lesion, or genetic methods. In these studies, experimental manipulations of specific brain regions provide direct evidence for involvement of the basal ganglia, cerebellum, thalamus and other regions. Additional evidence also comes from human studies using neuropathological, neuroimaging, non-invasive brain stimulation, and surgical interventions. In these studies, the evidence is less conclusive, because discriminating the regions that cause dystonia from those that reflect secondary responses to abnormal movements is more challenging. Discussion Overall, the evidence from both animals and humans suggests that different regions may play important roles in different subtypes of dystonia. The evidence so far provides strong support for the motor network model. There are obvious challenges, but also advantages, of attempting to translate knowledge gained from animals into a more complete understanding of human dystonia and novel therapeutic strategies.
Collapse
Affiliation(s)
- H. A. Jinnah
- Departments of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, GA, USA
| | - Vladimir Neychev
- Department of Surgery, University Multiprofile Hospital for Active Treatment “Alexandrovska”, Medical University of Sofia, Sofia, Bulgaria
| | - Ellen J. Hess
- Departments of Pharmacology and Neurology, Emory University, Atlanta, GA, USA
| |
Collapse
|
16
|
Vilany L, de Rezende TJR, Piovesana LG, Campos LS, de Azevedo PC, Torres FR, França MC, Amato-Filho AC, Lopes-Cendes I, Cendes F, D’Abreu A. Exploratory structural assessment in craniocervical dystonia: Global and differential analyses. PLoS One 2017; 12:e0182735. [PMID: 28829782 PMCID: PMC5567646 DOI: 10.1371/journal.pone.0182735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 07/24/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Our goal was to investigate the cortical thickness and subcortical volume in subjects with craniocervical dystonia and its subgroups. Methods We studied 49 subjects, 17 with cervical dystonia, 18 with blepharospasm or oromandibular dystonia, and 79 healthy controls. We performed a whole group analysis, followed by a subgroup analysis. We used Freesurfer software to measure cortical thickness, subcortical volume and to perform a primary exploratory analysis in the craniocervical dystonia group, complemented by a region of interest analysis. We also performed a secondary analysis, with data generated from Freesurfer for subgroups, corrected by false discovery rate. We then performed an exploratory generalized linear model with significant areas for the previous steps using clinical features as independent variables. Results The primary exploratory analysis demonstrated atrophy in visual processing regions in craniocervical dystonia. The secondary analysis demonstrated atrophy in motor, sensory, and visual regions in blepharospasm or oromandibular dystonia, as well as in limbic regions in cervical dystonia. Cervical dystonia patients also had greater cortical thickness than blepharospasm or oromandibular dystonia patients in frontal pole and medial orbitofrontal regions. Finally, we observed an association between precuneus, age of onset of dystonia and age at the MRI exam, in craniocervical dystonia; between motor and limbic regions and age at the exam, clinical score and time on botulinum toxin in cervical dystonia and sensory regions and age of onset and time on botulinum toxin in blepharospasm or oromandibular dystonia. Conclusions We detected involvement of visual processing regions in craniocervical dystonia, and a pattern of involvement in cervical dystonia and blepharospasm or oromandibular dystonia, including motor, sensory and limbic areas. We also showed an association of cortical thickness atrophy and younger onset age, older age at the MRI exam, higher clinical score and an uncertain association with longer time on botulinum toxin.
Collapse
Affiliation(s)
- Larissa Vilany
- Neuroimaging Laboratory, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- * E-mail:
| | - Thiago J. R. de Rezende
- Neuroimaging Laboratory, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- Chronology and Cosmic Rays Department, State University of Campinas, Campinas, SP, Brazil
| | - Luiza G. Piovesana
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Lidiane S. Campos
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Paula C. de Azevedo
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Fabio R. Torres
- Medical Genetics Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Marcondes C. França
- Neuroimaging Laboratory, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Augusto C. Amato-Filho
- Radiology Department—School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Iscia Lopes-Cendes
- Medical Genetics Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Anelyssa D’Abreu
- Neuroimaging Laboratory, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- Neurology Department, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| |
Collapse
|
17
|
de Azevedo PC, Guimarães RP, Piccinin CC, Piovesana LG, Campos LS, Zuiani JR, Tamashiro EM, Pinheiro G, Amato-Filho AC, Cendes F, Lopes-Cendes I, D’Abreu A. Cerebellar Gray Matter Alterations in Huntington Disease: A Voxel-Based Morphometry Study. THE CEREBELLUM 2017; 16:923-928. [DOI: 10.1007/s12311-017-0865-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
18
|
Czekóová K, Zemánková P, Shaw DJ, Bareš M. Social cognition and idiopathic isolated cervical dystonia. J Neural Transm (Vienna) 2017; 124:1097-1104. [DOI: 10.1007/s00702-017-1725-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/17/2017] [Indexed: 01/15/2023]
|
19
|
Nibbeling EAR, Delnooz CCS, de Koning TJ, Sinke RJ, Jinnah HA, Tijssen MAJ, Verbeek DS. Using the shared genetics of dystonia and ataxia to unravel their pathogenesis. Neurosci Biobehav Rev 2017; 75:22-39. [PMID: 28143763 DOI: 10.1016/j.neubiorev.2017.01.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/09/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022]
Abstract
In this review we explore the similarities between spinocerebellar ataxias and dystonias, and suggest potentially shared molecular pathways using a gene co-expression network approach. The spinocerebellar ataxias are a group of neurodegenerative disorders characterized by coordination problems caused mainly by atrophy of the cerebellum. The dystonias are another group of neurological movement disorders linked to basal ganglia dysfunction, although evidence is now pointing to cerebellar involvement as well. Our gene co-expression network approach identified 99 shared genes and showed the involvement of two major pathways: synaptic transmission and neurodevelopment. These pathways overlapped in the two disorders, with a large role for GABAergic signaling in both. The overlapping pathways may provide novel targets for disease therapies. We need to prioritize variants obtained by whole exome sequencing in the genes associated with these pathways in the search for new pathogenic variants, which can than be used to help in the genetic counseling of patients and their families.
Collapse
Affiliation(s)
- Esther A R Nibbeling
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Cathérine C S Delnooz
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Tom J de Koning
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Richard J Sinke
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Hyder A Jinnah
- Departments of Neurology, Human Genetics and Pediatrics, Emory Clinic, Atlanta, USA
| | - Marina A J Tijssen
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Dineke S Verbeek
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands.
| |
Collapse
|
20
|
Prudente CN, Stilla R, Singh S, Buetefisch C, Evatt M, Factor SA, Freeman A, Hu XP, Hess EJ, Sathian K, Jinnah HA. A Functional Magnetic Resonance Imaging Study of Head Movements in Cervical Dystonia. Front Neurol 2016; 7:201. [PMID: 27895619 PMCID: PMC5108767 DOI: 10.3389/fneur.2016.00201] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/31/2016] [Indexed: 12/24/2022] Open
Abstract
Cervical dystonia (CD) is a neurological disorder characterized by abnormal movements and postures of the head. The brain regions responsible for these abnormal movements are not well understood, because most imaging techniques for assessing regional brain activity cannot be used when the head is moving. Recently, we mapped brain activation in healthy individuals using functional magnetic resonance imaging during isometric head rotation, when muscle contractions occur without actual head movements. In the current study, we used the same methods to explore the neural substrates for head movements in subjects with CD who had predominantly rotational abnormalities (torticollis). Isometric wrist extension was examined for comparison. Electromyography of neck and hand muscles ensured compliance with tasks during scanning, and any head motion was measured and corrected. Data were analyzed in three steps. First, we conducted within-group analyses to examine task-related activation patterns separately in subjects with CD and in healthy controls. Next, we directly compared task-related activation patterns between participants with CD and controls. Finally, considering that the abnormal head movements in CD occur in a consistently patterned direction for each individual, we conducted exploratory analyses that involved normalizing data according to the direction of rotational CD. The between-group comparisons failed to reveal any significant differences, but the normalization procedure in subjects with CD revealed that isometric head rotation in the direction of dystonic head rotation was associated with more activation in the ipsilateral anterior cerebellum, whereas isometric head rotation in the opposite direction was associated with more activity in sensorimotor cortex. These findings suggest that the cerebellum contributes to abnormal head rotation in CD, whereas regions in the cerebral cortex are involved in opposing the involuntary movements.
Collapse
Affiliation(s)
| | - Randall Stilla
- Department of Neurology, Emory University , Atlanta, GA , USA
| | - Shivangi Singh
- Department of Neurology, Emory University , Atlanta, GA , USA
| | - Cathrin Buetefisch
- Department of Neurology, Emory University, Atlanta, GA, USA; Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA
| | - Marian Evatt
- Department of Neurology, Emory University, Atlanta, GA, USA; Atlanta Parkinson's Consortium Center, Atlanta VAMC, Decatur, GA, USA
| | | | - Alan Freeman
- Department of Neurology, Emory University , Atlanta, GA , USA
| | - Xiaoping Philip Hu
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University , Atlanta, GA , USA
| | - Ellen J Hess
- Department of Neurology, Emory University, Atlanta, GA, USA; Department of Pharmacology, Emory University, Atlanta, GA, USA
| | - K Sathian
- Department of Neurology, Emory University, Atlanta, GA, USA; Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA; Department of Psychology, Emory University, Atlanta, USA; Rehabilitation R&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, USA
| | - H A Jinnah
- Department of Neurology, Emory University, Atlanta, GA, USA; Department of Human Genetics, Emory University, Atlanta, GA, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA
| |
Collapse
|
21
|
Waugh JL, Kuster JK, Levenstein JM, Makris N, Multhaupt-Buell TJ, Sudarsky LR, Breiter HC, Sharma N, Blood AJ. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias. PLoS One 2016; 11:e0155302. [PMID: 27171035 PMCID: PMC4865047 DOI: 10.1371/journal.pone.0155302] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 04/27/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia. METHODS We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM) to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7). We used (1) automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2) blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume); and (3) voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus. RESULTS Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region. CONCLUSIONS Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches.
Collapse
Affiliation(s)
- Jeff L. Waugh
- Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Division of Child Neurology, Boston Children’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
- * E-mail:
| | - John K. Kuster
- Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America
- Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
| | - Jacob M. Levenstein
- Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
| | - Nikos Makris
- Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
| | | | - Lewis R. Sudarsky
- Department of Neurology, Brigham and Women’s Hospital, Boston MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Hans C. Breiter
- Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America
- Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Neurology, Brigham and Women’s Hospital, Boston MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Anne J. Blood
- Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America
- Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America
| |
Collapse
|
22
|
Bono F, Salvino D, Cerasa A, Vescio B, Nigro S, Quattrone A. Electrophysiological and structural MRI correlates of dystonic head rotation in drug-naïve patients with torticollis. Parkinsonism Relat Disord 2015; 21:1415-20. [PMID: 26482493 DOI: 10.1016/j.parkreldis.2015.09.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/12/2015] [Accepted: 09/27/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION We tested whether a change in head/neck position initiates head deviation in drug-naïve patients with cervical dystonia and to identify the electrophysiological and neuroanatomical correlates of dystonic head rotation. METHODS Twenty-five consecutive drug-naïve patients with cervical dystonia and 25 healthy controls underwent the simultaneous surface electromyographic (EMG) recording of sternocleidomastoid (SCM) muscle contractions during head/neck position changes, blink reflex recovery cycle (BRrc), DAT-SPECT, and advanced structural neuroimaging analysis using voxel-based morphometry (VBM). RESULTS Surface EMG recordings of SCM muscle activity during changes in head/neck position demonstrated an insignificant asymmetric low amplitude of the SCM muscle contractions in the horizontal position in both patients and controls, but an asymmetric high amplitude in SCM muscle contractions leading to abnormal head movements in vertical positions in patients with cervical dystonia. All controls had a symmetric low increase in amplitude of SCM muscle contractions in response to changes in head/neck position. VBM analysis in 19 patients showed abnormal decreases of gray matter (GM) volume in the bilateral motor (localized in the homunculus of the head) and premotor cortices when compared to controls. In addition, the side of these neuroanatomical changes was asymmetrically related to abnormal head deviations in these patients. All subjects had normal results during BRrc and DAT-SPECT. CONCLUSIONS The passage from inactive horizontal position to active vertical head/neck posture initiates head deviation in drug-naïve patients with cervical dystonia, and the anatomical correlates of this dystonic head rotation is a restricted abnormal pattern of GM changes in the motor cortices.
Collapse
Affiliation(s)
- Francesco Bono
- Institute of Neurology, Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy.
| | - Dania Salvino
- Institute of Neurology, Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro, Italy
| | - Antonio Cerasa
- Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy
| | - Basilio Vescio
- Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy
| | - Salvatore Nigro
- Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy
| | - Aldo Quattrone
- Institute of Neurology, Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy
| |
Collapse
|
23
|
Pinheiro GLS, Guimarães RP, Piovesana LG, Campos BM, Campos LS, Azevedo PC, Torres FR, Amato-Filho AC, França MC, Lopes-Cendes I, Cendes F, D'Abreu A. White Matter Microstructure in Idiopathic Craniocervical Dystonia. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2015; 5. [PMID: 26056610 PMCID: PMC4454992 DOI: 10.7916/d86972h6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 04/28/2015] [Indexed: 12/01/2022]
Abstract
Background Dystonias are hyperkinetic movement disorders characterized by involuntary muscle contractions resulting in abnormal torsional movements and postures. Recent neuroimaging studies in idiopathic craniocervical dystonia (CCD) have uncovered the involvement of multiple areas, including cortical ones. Our goal was to evaluate white matter (WM) microstructure in subjects with CCD using diffusion tensor imaging (DTI) analysis. Methods We compared 40 patients with 40 healthy controls. Patients were then divided into subgroups: cervical dystonia, blepharospasm, blepharospasm + oromandibular dystonia, blepharospasm + oromandibular dystonia + cervical dystonia, using tract-based spatial statistics. We performed a region of interest-based analysis and tractography as confirmatory tests. Results There was no significant difference in the mean fractional anisotropy (FA) and mean diffusivity (MD) between the groups in any analysis. Discussion The lack of DTI changes in CCD suggests that the WM tracts are not primarily affected.
Collapse
Affiliation(s)
- Giordanna L S Pinheiro
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Rachel P Guimarães
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Luiza G Piovesana
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Brunno M Campos
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Lidiane S Campos
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Paula C Azevedo
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Fabio R Torres
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Augusto C Amato-Filho
- Department of Radiology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Marcondes C França
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil ; Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Iscia Lopes-Cendes
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil ; Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Anelyssa D'Abreu
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Campinas, Brazil ; Department of Neurology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| |
Collapse
|