"Motor circuit" gray matter changes in idiopathic cervical dystonia
"Motor circuit" gray matter changes in idiopathic cervical dystonia
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DOI：
10.1212/01.wnl.0000094240.93745.83
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发表时间：
2003-11-11
期刊：
影响因子：
9.9
通讯作者：
May, A
中科院分区：
文献类型：
--
作者：
Draganski, B;Thun-Hohenstein, C;May, A
背景：特发性颈性肌张力障碍(ICD)是最常见的成人起病的局灶性肌张力障碍，其临床特征是头颈部肌肉的不自主单侧或双侧收缩。诊断ICD的一个重要标准是脑部MRI的正常结果。目的：验证ICD是否存在脑结构细微改变的假说。方法：采用基于体素的形态计量学方法，采用高分辨率磁共振成像技术，对10例ICD患者和10例年龄、性别相匹配的健康对照组的脑结构进行比较。结果：ICD患者双侧运动皮质、小脑小叶灰质密度增加，右侧苍白球内侧灰质密度增加。此外，还观察到右侧尾侧辅助运动区以及右侧背侧外侧前额叶和视皮层的灰质密度下降。结论：这些结果首次在体内证实了ICD的细微形态改变。这些数据挑战了ICD患者没有大脑结构异常，这种运动障碍完全是由于大脑功能异常的主要概念。
Background: Idiopathic cervical dystonia (ICD), the most common adult-onset focal dystonia, is clinically characterized by involuntary uni- or bilateral contractions of head and neck musculature. One crucial criterion for the diagnosis of ICD is normal results on MRI of the brain. Objective: To test the hypothesis whether subtle brain structure changes occur in ICD. Methods: Using voxel-based morphometry, the authors compared the brain structure of 10 patients with ICD with that of 10 healthy sex- and age-matched controls using high-resolution MRI. Results: Patients with ICD showed an increase in gray matter density bilaterally in the motor cortex and in the cerebellar flocculus and unilaterally in the right globus pallidus internus. In addition, a decrease in gray matter density was observed in the right caudal supplementary motor area as well as in the right dorsal lateral prefrontal and visual cortex. Conclusions: These results demonstrate for the first time in vivo subtle morphologic alterations in ICD. These data challenge the principal concept that patients with ICD have no brain structure abnormalities and that this movement disorder is solely due to abnormal cerebral function.