Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School and Massachusetts Eye and Ear, Boston, Massachusetts, USA.
Department of Neurology-Massachusetts General Hospital, Boston, Massachusetts, USA.
Mov Disord. 2023 Oct;38(10):1925-1935. doi: 10.1002/mds.29557. Epub 2023 Jul 25.
BACKGROUND AND OBJECTIVE: Laryngeal dystonia (LD) is focal task-specific dystonia, predominantly affecting speech but not whispering or emotional vocalizations. Prior neuroimaging studies identified brain regions forming a dystonic neural network and contributing to LD pathophysiology. However, the underlying temporal dynamics of these alterations and their contribution to the task-specificity of LD remain largely unknown. The objective of the study was to identify the temporal-spatial signature of altered cortical oscillations associated with LD pathophysiology. METHODS: We used high-density 128-electrode electroencephalography (EEG) recordings during symptomatic speaking and two asymptomatic tasks, whispering and writing, in 24 LD patients and 22 healthy individuals to investigate the spectral dynamics, spatial localization, and interregional effective connectivity of aberrant cortical oscillations within the dystonic neural network, as well as their relationship with LD symptomatology. RESULTS: Symptomatic speaking in LD patients was characterized by significantly increased gamma synchronization in the middle/superior frontal gyri, primary somatosensory cortex, and superior parietal lobule, establishing the altered prefrontal-parietal loop. Hyperfunctional connectivity from the left middle frontal gyrus to the right superior parietal lobule was significantly correlated with the age of onset and the duration of LD symptoms. Asymptomatic whisper in LD patients had not no statistically significant changes in any frequency band, whereas asymptomatic writing was characterized by significantly decreased synchronization of beta-band power localized in the right superior frontal gyrus. CONCLUSION: Task-specific oscillatory activity of prefrontal-parietal circuitry is likely one of the underlying mechanisms of aberrant heteromodal integration of information processing and transfer within the neural network leading to dystonic motor output. © 2023 International Parkinson and Movement Disorder Society.
背景与目的:喉痉挛(LD)是一种局灶性任务特异性痉挛,主要影响言语,但不影响耳语或情绪性发声。先前的神经影像学研究确定了形成痉挛神经网络并有助于 LD 病理生理学的大脑区域。然而,这些改变的潜在时间动态及其对 LD 任务特异性的贡献在很大程度上仍然未知。本研究的目的是确定与 LD 病理生理学相关的皮质振荡改变的时空特征。
方法:我们使用高密度 128 电极脑电图(EEG)记录在 24 例 LD 患者和 22 名健康个体在症状性说话和两个无症状任务(耳语和书写)期间的记录,以研究异常皮质振荡的频谱动态、空间定位和神经网络内的区域间有效连接,以及它们与 LD 症状的关系。
结果:LD 患者的症状性说话表现为中/额上回、初级体感皮层和上顶叶皮层的伽马同步显著增加,从而建立了改变的额顶叶循环。从左中额回到右顶叶上回的超功能连接与发病年龄和 LD 症状持续时间显著相关。LD 患者的无症状耳语在任何频带均无统计学意义上的变化,而无症状书写则表现为右侧额上回的β频带功率同步显著降低。
结论:额顶叶回路的任务特异性振荡活动可能是导致神经网络内信息处理和转移的异常异模态整合的潜在机制之一,从而导致痉挛性运动输出。© 2023 国际帕金森病和运动障碍学会。
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