Department of Neurology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany.
Department of Neuroradiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany.
J Neurol Neurosurg Psychiatry. 2014 Nov;85(11):1245-52. doi: 10.1136/jnnp-2013-307127. Epub 2014 Apr 4.
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).
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.
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.
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.
特定任务性手部局限性肌张力障碍会损害进行精细运动技能（如书写）时手臂肌肉的控制（书写痉挛（WC））。功能成像在这种障碍中发现了感觉运动区域的异常与任务相关的激活，但对其功能连接（FC）知之甚少。
使用静息态 fMRI 和感兴趣区（ROI）-体素交叉相关分析，对 15 名右侧 WC 患者和 15 名健康志愿者的小脑-基底节-丘脑-皮质网络中的多个 ROI 之间的 FC 进行系统分析。
与对照组相比，WC 患者几个种子 ROI（左侧外侧运动前皮质、左侧丘脑、左侧/右侧苍白球）与症状性左侧初级感觉运动皮质的正 FC 降低。左侧初级运动皮质与前额叶区域、补充运动前区和右侧躯体感觉皮质的 FC 降低，与疾病严重程度相关。几个小脑种子 ROI（右侧齿状核、右侧小脑脚 I 和双侧小脑脚 II）对初级和次级感觉运动区域的负 FC 增强。
静息时小脑皮质 FC 的增加与小脑在肌张力障碍中的致病作用假说一致。皮质下皮质 FC 的正缺陷表明，WC 中初级感觉运动区以外的基底节-丘脑-皮质运动环路存在更普遍的变化。由于 WC 患者在休息时无症状，这些功能网络变化可能反映了该疾病中网络结构的潜在异常或代偿性神经可塑性变化。
