White Matter Microstructural Changes Using Ultra-Strong Diffusion Gradient MRI in Adult-Onset Idiopathic Focal Cervical Dystonia.

Neurology

From the Cardiff University Brain Research Imaging Centre (C.L.M., D.J., K.G., A.D., C.M.W.T.), Cardiff University; Neuroscience and Mental Health Research Institute (C.L.M., K.J.P.), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine; North Bristol NHS Trust (K.S.-K.), United Kingdom; and Image Sciences Institute (C.M.W.T.), University Medical Center Utrecht, the Netherlands.

Published: August 2024

AI Article Synopsis

  • * Participants included 46 individuals with AOIFCD and 30 healthy controls, who underwent comprehensive clinical evaluations and advanced MRI techniques to analyze microstructural differences in their brain's motor pathways.
  • * Significant findings revealed altered microstructural properties in key areas such as the anterior thalamic radiations and thalamopremotor tracts among those with AOIFCD, indicating potential neurobiological factors contributing to the condition.

Article Abstract

Background And Objectives: Adult-onset idiopathic focal cervical dystonia (AOIFCD) involves abnormal posturing of the cervical musculature and, in some individuals, an associated head tremor. Existing neuroimaging studies have implicated key motor networks. However, measures used to date lack specificity toward underlying pathophysiologic differences. We aim to assess white matter motor pathways for localized, microstructural differences, which may aid in understanding underlying mechanisms.

Methods: Individuals diagnosed with AOIFCD and an age- and sex-matched control group were prospectively recruited through the Welsh Movement Disorders Research Network. All participants underwent in-depth clinical phenotyping and MRI (structural and diffusion sequences) using ultra-strong diffusion gradients. Tractography (whole-tract median values) and tractometry (along tract profiling) were performed for key white matter motor pathways assessing diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and standard model parameters. Groups were compared using linear model analysis with Bonferroni multiple comparison correction.

Results: Fifty participants with AOIFCD and 30 healthy control participants were recruited, with 46 with AOIFCD and 30 healthy controls included for analysis (33 without head tremor, 13 with head tremor). Significant differences were observed in the anterior thalamic radiations (lower mid-tract fractional anisotropy [estimate = -0.046, = 3.07 × 10], radial kurtosis [estimate = -0.165, = 1.42 × 10], -intra-axonal signal fraction [estimate = -0.044, = 2.78 × 10], orientation coherence [estimate = -0.043, = 1.64 × 10], higher Orientation Dispersion Index [ODI, estimate = 0.023, = 2.22 × 10]) and thalamopremotor tracts (higher mid-tract mean kurtosis [estimate = 0.064, = 7.56 × 10], lower Neurite Density Index [estimate = 0.062, = 2.1 × 10], higher distal tract ODI [estimate = 0.062, = 3.1 × 10], lower [estimate = -0.1, = 2.3 × 10], and striatopremotor tracts [proximal lower : estimate = -0.075, = 1.06 × 10]). These measures correlated with clinical measures: dystonia duration (right thalamopremotor distal ODI: = -0.9, = 1.29 × 10), psychiatric symptoms (obsessive compulsive symptoms: left anterior thalamic radiation = 0.92, = 2.797 × 10), sleep quality (Sleep Disorders Questionnaire Score: left anterior thalamic radiation ODI: = -0.84, = 4.84 × 10), pain (left anterior thalamic radiation ODI: = -0.89, = 1.4 × 10), and cognitive functioning (paired associated learning task , = 0.94, = 6.68 × 10).

Discussion: Overall, localized microstructural differences were identified within tracts linking the prefrontal and premotor cortices with thalamic and basal ganglia regions, suggesting pathophysiologic processes involve microstructural aberrances of motor system modulatory pathways, particularly involving intra-axonal and fiber orientation dispersion measures.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319067PMC
http://dx.doi.org/10.1212/WNL.0000000000209695DOI Listing

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