Department of Neurology, School of Medicine, Tongji Hospital, Neurotoxin Research Center, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
Department of Nuclear Medicine, School of Medicine, Tongji Hospital, Tongji University, 389 Xincun Road, Shanghai, 200065, China.
J Neural Transm (Vienna). 2022 Mar;129(3):311-317. doi: 10.1007/s00702-022-02469-6. Epub 2022 Feb 7.
Torticaput is the most common primary form of cervical dystonia (CD). Obliquus capitis inferior (OCI) plays a major role in ipsilateral rotation of the head. The present study aimed to use single-photon emission computed tomography (SPECT/CT) to determine the involvement of OCI in torticaput and in torticaput associated with no-no tremor. We retrospectively analyzed the SPECT/CT images of 60 patients with torticaput as the main abnormal posture and ranked the affected muscles. The affected muscles in patients with no-no tremor were also ranked. The correlation between the radioactivity of OCI and the thickness of OCI measured by ultrasonography was analyzed. The agreement between SPECT/CT and electromyography in detecting OCI was also analyzed. After sternocleidomastoid muscle (81.7%), OCI was the second most affected muscle (70.0%) in torticaput, followed by splenius capitis (63.3%). In 23 patients with no-no tremor, OCI (78.3%) and sternocleidomastoid muscle (78.3%) were the most frequently affected muscles, followed by splenius capitis (69.6%). Furthermore, bilateral muscle involvement was commonly seen in patients with no-no tremor, especially for OCI (12/23) and sternocleidomastoid muscle (11/23). A positive correlation was found between the radioactivity and thickness of OCI (r = 0.330, P < 0.001). The total agreement rate between SPECT/CT and electromyography in the diagnosis of OCI excitement was 94.0%, with kappa value = 0.866 (P < 0.001). OCI plays a critical role in torticaput and no-no tremor. SPECT/CT could be a practical tool to help clinicians detect abnormally excited OCI.
斜角肌（OCI）在下斜方肌中起着主要的作用，使头部向同侧旋转。本研究旨在使用单光子发射计算机断层扫描（SPECT/CT）来确定OCI 在斜颈（CD）中的作用，以及在伴有无震颤的斜颈中的作用。我们回顾性地分析了 60 例以斜颈为主要异常姿势的患者的 SPECT/CT 图像，并对受累肌肉进行了排序。还对无震颤的患者的受累肌肉进行了排序。分析了 OCI 的放射性与超声测量的 OCI 厚度之间的相关性。分析了 SPECT/CT 与肌电图在检测 OCI 中的一致性。在胸锁乳突肌（81.7%）之后，OCI 是斜颈中第二大受累肌肉（70.0%），其次是头夹肌（63.3%）。在 23 例无震颤的患者中，OCI（78.3%）和胸锁乳突肌（78.3%）是最常受累的肌肉，其次是头夹肌（69.6%）。此外，无震颤的患者通常存在双侧肌肉受累，尤其是 OCI（12/23）和胸锁乳突肌（11/23）。OCI 的放射性与厚度之间存在正相关（r=0.330，P<0.001）。SPECT/CT 和肌电图在诊断 OCI 兴奋方面的总一致性率为 94.0%，kappa 值=0.866（P<0.001）。OCI 在斜颈和无震颤中起着关键作用。SPECT/CT 可能是帮助临床医生检测异常兴奋的 OCI 的实用工具。
