Diffusion Abnormalities in the Primary Sensorimotor Pathways in Writer's Cramp
Diffusion Abnormalities in the Primary Sensorimotor Pathways in Writer's Cramp
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DOI：
10.1001/archneurol.2009.8
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发表时间：
2009-04-01
影响因子：
--
通讯作者：
Lehericy, Stephane
中科院分区：
文献类型：
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作者：
Delmaire, Christine;Vidailhet, Marie;Lehericy, Stephane
目的：使用基于体素的扩散分析和纤维追踪来确定书写痉挛患者中连接感觉运动区域（包括初级感觉运动区和纹状体）的纤维是否沿着存在扩散异常。最近的研究表明，在书写痉挛中这些区域的结构变化。设计：患者和对照组比较。设置：运动障碍转诊中心。参与者：26名右利手书写痉挛患者和26名右利手健康对照受试者，性别和年龄相匹配。干预：临床运动评估。主要结果测量：书写痉挛中纤维跟踪的分数各向异性变化和结果。扩散-张量成像显示，作者的患者内囊后肢和邻近结构的白色物质双侧各向异性分数增加抽筋了纤维追踪表明，分数各向异性的变化涉及纤维束连接的主要感觉运动区与皮层下结构。结论：扩散异常存在于纤维束连接的主要感觉运动区与皮层下结构在书写痉挛。这些异常加强了皮质下皮质通路在书写痉挛病理生理机制中的作用。
Objective: To determine whether there are diffusion abnormalities along the fibers connecting sensorimotor regions, including the primary sensorimotor areas and the striatum, in patients with writer's cramp using voxel-based diffusion analysis and fiber tracking. Recent studies have shown structural changes in these regions in writer's cramp.Design: Patient and control group comparison.Setting: Referral center for movement disorders.Participants: Twenty-six right-handed patients with writer's cramp and 26 right-handed healthy control subjects matched for sex and age.Interventions: Clinical motor evaluations.Main Outcome Measures: Fractional anisotropy changes and results of fiber tracking in writer's cramp.Results: Diffusion-tensor imaging revealed increased fractional anisotropy bilaterally in the white matter of the posterior limb of the internal capsule and adjacent structures in the patients with writer's cramp. Fiber tracking demonstrated that fractional anisotropy changes involve fiber tracts connecting the primary sensorimotor areas with subcortical structures.Conclusions: Diffusion abnormalities are present in fiber tracts connecting the primary sensorimotor areas with subcortical structures in writer's cramp. These abnormalities strengthen the role of the corticosubcortical pathways in the pathophysiologic mechanisms of writer's cramp.