Grimm Kai, Braaß Hanna, Sadeghi Fatemeh, Gelderblom Mathias, Schulz Robert, Zittel Simone
Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Neurol. 2025 Jun 3;272(6):441. doi: 10.1007/s00415-025-13186-x.
Cervical dystonia (CD) has been recognized as a disorder of the brain's sensorimotor network. Within this malfunctioning network, the cerebellum plays an important role that needs to be further characterized.
To investigate the structural connectivity of the dentato-rubro-thalamic tract (DRTT), probabilistic tractography was performed in 18 CD patients and 18 matched healthy control (HC) subjects. Connectivity was quantified with fractional anisotropy (FA). Thirteen subjects in each group also participated in a neurophysiological double-blind experiment to investigate the effect of cathodal and sham cerebellar transcranial direct current stimulation (ctDCS) on sensorimotor associative plasticity, as evoked by paired associative stimulation (PAS). The association of FA of the DRTT and neurophysiological parameters was studied with linear models.
The FA of the DRTT was not different between the groups and not related to motor symptom severity in CD patients. In the HC group, there was a significant association between the structural connectivity of the DRTT and the effect that cathodal ctDCS had on the PAS effect. This association was not found in CD patients.
The microstructural state of the DRTT is a potential biomarker for the efficacy of ctDCS in HC. The lack of this structure-function association in patients is further evidence of abnormal properties of the cerebellar motor network in CD.
颈部肌张力障碍(CD)已被公认为是一种大脑感觉运动网络的疾病。在这个功能失调的网络中,小脑起着重要作用,这一作用需要进一步明确。
为了研究齿状红核丘脑束(DRTT)的结构连接性,对18例CD患者和18例匹配的健康对照(HC)受试者进行了概率性纤维束成像。用分数各向异性(FA)对连接性进行量化。每组中的13名受试者还参与了一项神经生理学双盲实验,以研究阴极和假小脑经颅直流电刺激(ctDCS)对由配对联想刺激(PAS)诱发的感觉运动联合可塑性的影响。用线性模型研究DRTT的FA与神经生理学参数之间的关联。
两组之间DRTT的FA无差异,且与CD患者的运动症状严重程度无关。在HC组中,DRTT的结构连接性与阴极ctDCS对PAS效应的影响之间存在显著关联。在CD患者中未发现这种关联。
DRTT的微观结构状态是ctDCS对HC疗效的潜在生物标志物。患者中这种结构-功能关联的缺失进一步证明了CD中小脑运动网络的异常特性。