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Brain Structural Changes in Focal Dystonia—What About Task Specificity? A Multimodal MRI Study
Author(s) -
Tomić Aleksandra,
Agosta Federica,
Sarasso Elisabetta,
Svetel Marina,
Kresojević Nikola,
Fontana Andrea,
Canu Elisa,
Petrović Igor,
Kostić Vladimir S.,
Filippi Massimo
Publication year - 2021
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.28304
Subject(s) - focal dystonia , dystonia , basal ganglia , neuroscience , thalamus , white matter , cervical dystonia , psychology , magnetic resonance imaging , medicine , blepharospasm , putamen , voxel based morphometry , botulinum toxin , central nervous system , radiology
ABSTRACT Background The neural basis of task specificity in dystonia is still poorly understood. This study investigated gray and white matter (WM) brain alterations in patients with task‐specific dystonia (TSD) and non‐task‐specific dystonia (NTSD). Methods Thirty‐six patients with TSD (spasmodic dysphonia, writer's cramp), 61 patients with NTSD (blepharospasm, cervical dystonia), and 83 healthy controls underwent 3D T1‐weighted and diffusion tensor magnetic resonance imaging (MRI). Whole brain cortical thickness and voxel‐based morphometry; volumes of basal ganglia, thalamus, nucleus accumbens, amygdala, and hippocampus; and WM damage were assessed. Analysis of variance models were used to compare MRI measures between groups, adjusting for age and botulinum toxin (BoNT) treatment. Results The comparison between focal dystonia patients showed cortical thickness and gray matter (GM) volume differences (ie, decreased in NTSD, increased in TSD) in frontal, parietal, temporal, and occipital cortical regions; basal ganglia; thalamus; hippocampus; and amygdala. Cerebellar atrophy was found in NTSD patients relative to controls. WM damage was more severe and widespread in task‐specific relative to NTSD patients. TSD patients receiving BoNT, relative to nontreated patients, had cortical thickening and increased GM volume in frontoparietal, temporal, and occipital regions. NTSD patients experiencing pain showed cortical thickening of areas involved in pain‐inhibitory mechanisms. Conclusions TSD and NTSD are characterized by opposite alterations of the main cortical and subcortical sensorimotor and cognitive‐controlling brain structures, suggesting the possible presence of different pathophysiological and/or compensatory mechanisms underlying the complexity of the two clinical phenotypes of focal dystonia. © 2020 International Parkinson and Movement Disorder Society