Multiple changes of functional connectivity between sensorimotor areas in focal hand dystonia
Multiple changes of functional connectivity between sensorimotor areas in focal hand dystonia
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DOI：
10.1136/jnnp-2013-307127
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发表时间：
2014-11-01
影响因子：
11
通讯作者：
Haslinger, Bernhard
中科院分区：
文献类型：
--
作者：
Dresel, Christian;Li, Yong;Haslinger, Bernhard
背景：任务性局灶性手部肌张力障碍在精细运动技能(如写字抽筋)过程中会损害手臂肌肉的控制。结果15例右侧WC患者和15例健康志愿者静息状态fMRI和感兴趣区(ROI)体素互相关分析显示，右侧WC患者和15例健康志愿者小脑-基底节-丘脑皮质网络内多个感兴趣区(ROI)之间的FC值明显低于正常对照组。左侧初级运动皮质至前额叶、前辅助运动区和右侧躯体感觉皮质的Fc降低，且与病情严重程度相关。多个小脑种子ROI(右侧齿状核、右侧小腿I和双侧小腿II)对初级和次级感觉运动区显示较强的负性FC。结论静息状态下小脑皮质负性FC的增加符合小脑在肌张力障碍中的致病作用假说。皮质下Fc阳性的缺失提示在WC的初级感觉运动区以外的基底节-丘脑皮质运动环内有更广泛的改变。由于WC患者在休息时没有症状，这些功能网络的变化可能反映了这种疾病中潜在的网络结构异常或代偿性神经可塑性变化。
Background Task-specific focal hand dystonia impairs the control of arm muscles during fine motor skills such as writing (writer's cramp (WC)). Functional imaging found abnormal task-related activation of sensorimotor areas in this disorder, but little is known on their functional connectivity (FC).Methods Resting-state fMRI and regions of interest (ROI)-voxel cross-correlation analyses were used for systematically analysing the FC between multiple ROIs within the cerebello-basal ganglia-thalamocortical network in 15 patients with right-sided WC and 15 healthy volunteers.Results Patients with WC showed a lower positive FC of several seed ROIs (left lateral premotor cortex, left thalamus, left/right pallidum) to the symptomatic left primary sensorimotor cortex compared with controls. The FC of the left primary motor cortex to prefrontal areas, pre-supplementary motor area and right somatosensory cortex was reduced and correlated with disease severity. Several cerebellar seed ROIs (right dentate nucleus, right crus I and bilateral crus II) revealed a stronger negative FC to primary and secondary sensorimotor areas.Conclusions An increase of negative cerebello-cortical FC at rest is in line with the hypothesis of a pathogenetic role of the cerebellum in dystonia. The deficit of positive subcortico-cortical FC indicates more generalised changes within the basal ganglia-thalamocortical motor loops beyond primary sensorimotor areas in WC. As patients with WC are asymptomatic during rest, these functional network changes could reflect an underlying abnormality or compensatory neuroplastic changes of network architecture in this disorder.