Structural white matter abnormalities in patients with idiopathic dystonia |
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| Authors: | Leonardo Bonilha MD PhD Paulien M. de Vries Diana J. Vincent MD PhD Chris Rorden MD PhD Paul S. Morgan Mark W. Hurd PhD Nada Besenski MD Kenneth J. Bergmann MD Vanessa K. Hinson MD PhD |
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| Affiliation: | 1. Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA;2. Department of Neuropsychiatry, University of South Carolina, Columbia, South Carolina, USA;3. Department of Neurology, Neuroimaging Center, Institute of Behavioral and Cognitive Neuroscience, University of Groningen, Groningen, The Netherlands;4. Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA;5. Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina, USA;6. Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA;7. Division of Academic Radiology, University of Nottingham, Nottingham, United Kingdom;8. Department of Psychology, College of Charleston, Charleston, South Carolina, USA;9. Murray Center for Research on Parkinson's Disease and Related Disorders, Medical University of South Carolina, Charleston, South Carolina, USA;10. Murray Center for Research on Parkinson's Disease and Related Disorders, Medical University of South Carolina, Charleston, South Carolina, USACharleston Memorial Hospital, 326 Calhoun Street, Suite 308, Charleston, SC 29425 |
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| Abstract: | We investigated whether structural white matter abnormalities, in the form of disruption of axonal coherence and integrity as measured with diffusion tensor imaging (DTI), constitute an underlying pathological mechanism of idiopathic dystonia (ID), independent of genotype status. We studied seven subjects with ID: all had cervical dystonia as their main symptom (one patient also had spasmodic dysphonia and two patients had concurrent generalized dystonia, both DYT1‐negative). We compared DTI MR images of patients with 10 controls, evaluating differences in mean diffusivity (MD) and fractional anisotropy (FA). ID was associated with increased FA values in the thalamus and adjacent white matter, and in the white matter underlying the middle frontal gyrus. ID was also associated with increase in MD in adjacent white matter to the pallidum and putamen bilaterally, left caudate, and in subcortical hemispheric regions, including the postcentral gyrus. Abnormal FA and MD in patients with ID indicate that abnormal axonal coherence and integrity contribute to the pathophysiology of dystonia. These findings suggest that ID is not only a functional disorder, but also associated with structural brain changes. Impaired connectivity and disrupted flow of information may contribute to the impairment of motor planning and regulation in dystonia. © 2006 Movement Disorder Society |
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| Keywords: | dystonia white matter diffusion tensor imaging MRI pathophysiology |
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