Increased volume and impaired function: the role of the basal ganglia in writer's cramp

Brain and Behavior

Kirsten E. Zeuner³  Arne Knutzen³  Oliver Granert³  Julia Götz³  Stephan Wolff²  Olav Jansen²  Dirk Dressler¹  Harald Hefter⁴  Mark Hallett⁵  Günther Deuschl³  Thilo van Eimeren³ 

[1] Movement Disorders Section, Department of Neurology, Hannover Medical School, Hannover, Germany;Department of Neuroradiology, Kiel University, Kiel, Germany;Department of Neurology, Kiel University, Kiel, Germany;Department of Neurology, University of Düsseldorf, Düsseldorf, Germany;Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland

关键词: Focal hand dystonia;    functional magnetic resonance imaging;    motor learning;    voxel‐based morphometry;    writer's cramp;   

DOI  :  10.1002/brb3.301

来源: Wiley

【 摘 要 】

Abstract

Introduction

The pathophysiology of writer's cramp, a task-specific dystonia, remains unclear. The objective of this study was to investigate the basal ganglia circuit and the cerebellum during a complex motor sequence learning task carried out with the nonaffected hand in writer's cramp patients.

Methods

We applied structural and functional imaging in 22 writer's cramp patients and 28 matched controls using 3T MRI. With the asymptomatic left hand all participants learned a complex, sequential, five-element sequence-tapping task as accurately and quickly as possible. Functional imaging was measured during a repeated (15 times), fixed block design with tapping (30 sec) and rest (30 sec). Additionally, gray matter volume of the basal ganglia was analyzed using voxel-based morphometry (VBM).

Results

While behavior was comparable between groups, after small volume correction the anterior part of the right putamen and the left globus pallidus exhibited reduced blood oxygen level-dependent (BOLD) activity in patients during the sequential finger-tapping task. VBM analysis showed larger gray matter volume bilateral in the posterior part of the putamen and globus pallidus. There were no group differences in the cerebellum.

Conclusion

The results indicate an impairment of anterior basal ganglia loops involved in producing complex sequential movements of the unaffected hand. These findings are in line with previous reports of reduced neuronal activity in the globus pallidus internus. Higher gray matter volume of the putamen and globus pallidus may stem from elevated activity of the direct pathway, which could reflect a compensatory phenomenon or a primary predisposition, that is, endophenotypic trait.

【 授权许可】

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© 2014 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

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