Qiu Mingjing, Xiang Yongsheng, Li Lixi, Pan Lizhen, Song Yunping, Feng Liang, Jin Lingjing
Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University School of Medicine, Shanghai 200070, China.
Department of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
Brain Res Bull. 2025 Sep;229:111445. doi: 10.1016/j.brainresbull.2025.111445. Epub 2025 Jul 1.
Cerebellar abnormalities involved in cervical dystonia (CD) have gained increasing attention, but a consistent pattern of structural changes in the cerebellar lobules and peduncles has not been fully identified. Associations between cerebellar abnormalities and the phenotypic characteristics of CD patients have not been established.
Ninety CD patients and 52 healthy controls (HC) were selected from our database, including 52 with head tremor (trCD) and 38 without head tremor (ntrCD). Between-group differences in gray matter volumes of cerebellar subregions and fiber morphometric properties of the cerebellar peduncles (CP) were investigated using voxel-based, region of interest-based and fixel-based analysis, respectively. The significant structural changes were correlated with clinical data, including disease duration and the first section of TWSTRS.
Compared to HC, reduced fiber cross-section (FC) was found in the right inferior CP of CD patients. Furthermore, not only decreased gray matter volume in vermis Crus II, vermis VIIIa, vermis VIIIb, vermis IX, left Crus I and Crus II was detected, but also lesser FC in the left superior CP was observed in ntrCD patients. However, only reduced FC in the right inferior CP was shown in trCD patients. Notably, lower gray matter volume in the left Crus I was associated with a higher TWSTRS 1 score in patients with ntrCD (p = 0.007).
Our study provided potential evidence that structural cerebellar changes in CD patients, manifested as gray matter loss or CP atrophy, and structural changes may vary in patients with different phenotypic characteristics.
颈肌张力障碍（CD）所涉及的小脑异常已受到越来越多的关注，但小脑小叶和脚的结构变化的一致模式尚未完全明确。小脑异常与CD患者表型特征之间的关联尚未确立。
从我们的数据库中选取90例CD患者和52例健康对照（HC），其中包括52例有头部震颤的患者（trCD）和38例无头部震颤的患者（ntrCD）。分别使用基于体素、基于感兴趣区域和基于固定点的分析方法，研究小脑亚区域灰质体积和小脑脚（CP）纤维形态学特性的组间差异。将显著的结构变化与临床数据相关联，包括病程和TWSTRS的第一部分。
与HC相比，CD患者右侧下CP的纤维横截面积（FC）减小。此外，不仅在蚓部Crus II、蚓部VIIIa、蚓部VIIIb、蚓部IX、左侧Crus I和Crus II检测到灰质体积减少，而且在ntrCD患者中还观察到左侧上CP的FC较小。然而，trCD患者仅显示右侧下CP的FC降低。值得注意的是，ntrCD患者左侧Crus I灰质体积较低与较高的TWSTRS 1评分相关（p = 0.007）。
我们的研究提供了潜在证据，表明CD患者的小脑结构变化表现为灰质丢失或CP萎缩，并且不同表型特征的患者结构变化可能有所不同。
