Laryngeal and Speech Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bathesda, MD 20892, USA.
Cereb Cortex. 2010 Nov;20(11):2749-59. doi: 10.1093/cercor/bhq023. Epub 2010 Mar 1.
Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD.
痉挛性发音障碍(SD)是一种特定于任务的局灶性肌张力障碍,其病因不明,特征是在说话时喉部肌肉出现不自主痉挛。我们的目的是确定内收型痉挛性发音障碍(ADSD)和外展型痉挛性发音障碍(ABSD)患者在症状特异性功能脑激活方面的异常。在有症状和无症状任务中,两组 SD 患者初级感觉运动皮层、岛叶和颞上回的激活范围均增加,而在无症状任务中基底节、丘脑和小脑的激活范围均减少。在有症状的发声过程中,SD 患者初级躯体感觉皮层的激活强度仅增加,且与 ADSD 症状呈相关性趋势。在有症状和无症状任务中,两组 SD 患者初级运动和感觉皮层之间的激活强度相关性以及基底节、丘脑和小脑之间的额外相关性均降低。与 ADSD 患者相比,ABSD 患者在有症状的任务中初级感觉运动皮层和腹侧丘脑的激活范围更大,在有症状和无症状的发声过程中,下颞叶皮质和小脑的激活范围更大。初级躯体感觉皮层在 SD 患者的激活范围、强度、与其他脑区的相关性以及症状严重程度方面均存在一致性异常,因此可能与 SD 的病理生理学有关。
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