Reply: Role of cortico-pallidal connectivity in the pathophysiology of dystonia

Sir,We appreciate the opportunity to comment on the relevant Letter to the Editor by Cacciola and colleagues (2016). A great effort has been made throughout recent decades to define the various anatomical structures that are implicated in the pathophysiology of dystonia (Quartarone and Hallett, 2013). Dystonia is now considered to be a network disorder defining basal ganglia, cerebral cortex, cerebellum, thalamus and brainstem as major nodes (Lehericy et al. , 2013). The characterization of abnormal neuronal activation patterns in dystonia at different levels of the nervous system including the loss of inhibition, enhanced plasticity and abnormal sensorimotor integration, have shaped our view on the pathophysiology of dystonia. However, the functional roles of the different brain areas and their interaction within the sensorimotor network on the expression of variable dystonic symptoms remain to be elucidated (Lehericy et al. , 2013). Thus, we believe that the research focus should now shift from characterizing the involved structural components of the dystonia network to investigating network interactions and their role for dystonic …