Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Laboratory of Movement Analysis, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Neurol. 2020 Apr;267(4):1103-1115. doi: 10.1007/s00415-019-09683-5. Epub 2020 Jan 2.
Sensory trick may relieve dystonic symptoms in patients with idiopathic cervical dystonia (CD). We investigated the patterns of brain functional MRI (fMRI) during resting state, sensory trick simulation and sensory trick imagination in CD patients both with and without an effective sensory trick. We recruited 17 CD patients and 15 healthy controls. Nine patients (CD-trick) had an effective sensory trick, while 8 patients (CD-no-trick) did not. Cervical range of motion validated instrument assessed dystonic posture and sensory trick effect. Participants underwent resting state fMRI, which was repeated by patients while executing the sensory trick. Patients also performed an fMRI task in which they were asked to imagine a sensory trick execution. CD-trick and CD-no-trick patients were comparable in terms of CD severity. Applying the sensory trick, CD-trick patients significantly improved dystonic posture. CD-no-trick patients showed an increased functional connectivity of sensorimotor network relative to controls during classic resting state fMRI. During resting state fMRI with sensory trick, CD-trick patients showed a decrease of sensorimotor network connectivity. During the sensory trick imagination fMRI task, CD-trick relative to CD-no-trick patients increased the recruitment of cerebellum bilaterally. This study suggests a hyper-connectivity of sensorimotor areas during resting state in CD-no-trick subjects. In CD-trick patients, the sensory trick performance was associated with a decreased connectivity of the sensorimotor network. The increased activation of cerebellum in CD-trick patients during the sensory trick imagination suggests a possible role of this area in modulating cortical activity.
感觉技巧可能会缓解特发性颈肌张力障碍（CD）患者的运动障碍症状。我们研究了 CD 患者在静息状态、感觉技巧模拟和感觉技巧想象期间的脑功能磁共振成像（fMRI）模式，这些患者有的有有效的感觉技巧，有的没有。我们招募了 17 名 CD 患者和 15 名健康对照者。9 名患者（CD-有技巧）有有效的感觉技巧，而 8 名患者（CD-无技巧）没有。颈曲度验证仪评估了运动障碍姿势和感觉技巧的效果。参与者接受了静息状态 fMRI，患者在执行感觉技巧时重复进行了 fMRI。患者还进行了一项 fMRI 任务，要求他们想象执行感觉技巧。在 CD 严重程度方面，CD-有技巧和 CD-无技巧患者具有可比性。应用感觉技巧后，CD-有技巧患者的运动障碍姿势明显改善。与对照组相比，CD-无技巧患者在经典静息状态 fMRI 中显示出感觉运动网络的功能连接增加。在带有感觉技巧的静息状态 fMRI 中，CD-有技巧患者的感觉运动网络连接减少。在感觉技巧想象 fMRI 任务中，CD-有技巧患者相对于 CD-无技巧患者双侧小脑的招募增加。这项研究表明，CD-无技巧患者在静息状态下感觉运动区的连接过度。在 CD-有技巧患者中，感觉技巧的表现与感觉运动网络的连接减少有关。CD-有技巧患者在感觉技巧想象过程中小脑的活动增加表明该区域可能在调节皮质活动中发挥作用。
