Abstract
Background
The evidence suggests that the origin of primary dystonia is at least partly associated
with widespread dysfunction of the basal ganglia and cortico–striato–thalamo–cortical
circuits. The aim of the study was to assess the sensorimotor activation pattern outside
the circuits controlling the affected body part in cervical dystonia, as well as to
determine task-related activation changes induced by botulinum toxin type A (BoNT-A)
treatment.
Methods
Seven patients suffering from cervical dystonia and nine healthy controls were examined
with functional MRI during skilled hand motor task; the examination was repeated 4 weeks after BoNT-A application to dystonic neck muscles.
Results
Functional MRI data demonstrated overall reduced extent of hand movement-related cortical
activation but greater magnitude of blood oxygenation level dependent signal change
in the contralateral secondary somatosensory cortex in patients compared to controls.
Effective BoNT-A treatment led to reduced activation of the ipsilateral supplementary
motor area and dorsal premotor cortex in patients. The patients' post-treatment sensorimotor
maps showed significantly smaller basal ganglia activation compared to controls.
Conclusions
These results provide imaging evidence that abnormalities in sensorimotor activation
extend beyond circuits controlling the affected body parts in cervical dystonia. The
study also supports observations that BoNT-A effect has a correlate at central nervous
system level, and such effect may not be limited to cortical and subcortical representations
of the treated muscles.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Idiopathic cervical dystonia: an overview.Neurology. 2000; 12: S2-S8
- Convergent evidence for abnormal striatal synaptic plasticity in dystonia.Neurobiol Dis. 2010; 3: 558-573
- Sensory functions in dystonia: insights from behavioral studies.Mov Disord. 2009; 10: 1427-1436
- Does neurophysiological testing provide the information we need to improve the clinical management of primary dystonia?.Clin Neurophysiol. 2009; 8: 1424-1432
- Neuroimaging characteristics of patients with focal hand dystonia.J Hand Ther. 2009; 2: 125-134
- Silent event-related fMRI reveals deficient motor and enhanced somatosensory activation in orofacial dystonia.Brain. 2006; 1: 36-46
- Molding the sensory cortex: spatial acuity improves after botulinum toxin treatment for cervical dystonia.Mov Disord. 2007; 16: 2443-2446
- Change in lateralization of the P22/N30 cortical component of median nerve somatosensory evoked potentials in patients with cervical dystonia after successful treatment with botulinum toxin A.Mov Disord. 1998; 1: 108-117
- Cervical dystonia affects aimed movements of nondystonic segments.Mov Disord. 2009; 13: 1955-1961
- Treatment of cervical dystonia with botulinum toxin.Mov Disord. 2004; : S109-S115
- Neurophysiological effects of botulinum toxin type A.Neurotox Res. 2006; 9: 109-114
Tsui JK, Eisen A, Stoessl AJ, Calne S, Calne DB. Double-blind study of botulinum toxin in spasmodic torticollis. Lancet 1986;8501:245–247.
- Supplementary motor area and other cortical areas in organization of voluntary movements in man.J Neurophysiol. 1980; 1: 118-136
- The botulinum toxins in the treatment of cervical dystonia.Semin Neurol. 2001; 1: 85-90
- Correlation between motor improvements and altered fMRI activity after rehabilitative therapy.Brain. 2002; 125: 2731-2742
- Advances in functional and structural MR image analysis and implementation as FSL.Neuroimage. 2004; 23: S208-S219
- Transcranial magnetic stimulation of the human brain: responses in muscles supplied by cranial nerves.Exp Brain Res. 1988; 3: 623-632
- Corticomotor representation of the sternocleidomastoid muscle.Brain. 1997; 2: 245-255
- Abnormalities of somatosensory evoked potentials in spasmodic torticollis.Mov Disord. 1994; 9: 426-430
- Abnormal somatotopic arrangement of sensorimotor interactions in dystonic patients.Brain. 2002; 12: 2719-2730
- Impaired sensorimotor integration in cervical dystonia: a study using transcranial magnetic stimulation and muscle vibration.J Clin Neurophysiol. 2002; 3: 232-239
- Abnormal associative plasticity of the human motor cortex in writer's cramp.Brain. 2003; 12: 2586-2596
- Changed patterns of cerebral activation related to clinically normal hand movement in cervical dystonia.Clin Neurol Neurosurg. 2008; 12: 120-128
- Modulation in network activation during motor execution and motor imagery.Cereb Cortex. 2004; 14: 1246-1255
- Effects of movement and movement imagery on somatosensory evoked magnetic fields following posterior tibial nerve stimulation.Brain Res Cogn Brain Res. 1997; 3: 241-253
- Sensorimotor integration in movement disorders.Mov Disord. 2003; 3: 231-240
- Sensory disinhibition on passive movement in cervical dystonia.Mov Disord. 2010; 25: 2627-2633
- Abnormal sensorimotor plasticity in organic but not in psychogenic dystonia.Brain. 2009; 10: 2871-2877
- New concepts of the supplementary motor area.Curr Opin Neurobiol. 1996; 6: 782-787
- Sensory motor mismatch within the supplementary motor area in the dystonic monkey.Neurobiol Dis. 2008; 2: 151-161
- The primary motor and premotor areas of the human cerebral cortex.Neuroscientist. 2006; 2: 143-152
- Overactive prefrontal and underactive motor cortical areas in idiopathic dystonia.Ann Neurol. 1995; 3: 363-372
- Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer's cramp.Brain. 2005; 1: 104-115
- Increased basal-ganglia activation performing a non-dystonia-related task in focal dystonia.Eur J Neurol. 2008; 8: 831-838
Article info
Publication history
Published online: April 14, 2011
Accepted:
March 24,
2011
Received in revised form:
March 18,
2011
Received:
January 23,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
