Basal ganglia and thalamo-cortical hypermetabolism in patients with spasmodic torticollis.
The basal ganglia are thought to be involved in the primary dystonias, largely because of the repeated demonstration of neuropathological changes in these nuclei in the secondary dystonias. A hyperactivity of a network involving basal ganglia has been suggested in experimental animal dystonia. To test this hypothesis in humans, we studied the functional correlates of primary cervical dystonia using [18F]FDG and PET.


METHODS
Regional cerebral glucose metabolism (rCMRglc) was measured in 10 patients with idiopathic torticollis (6 drug-free and 4 drug-naive) and in 15 normal controls, using 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]FDG) and positron emission tomography (PET).


RESULTS
A significant hypermetabolism in the basal ganglia, thalamus, premotor-motor cortex and cerebellum in the patients compared with normal controls was found. The patients were correctly assigned to their clinical category by a discriminant function analysis with a total accuracy of 96%.


CONCLUSIONS
The results support the hypothesis that a dysfunction of a subcortical-cortical motor network may play a role in the pathogenesis of focal dystonia, in agreement with the experimental dystonia models.
Scientific Institute H San Raffaele, Milan, Italy.
G
G
Galardi
D
D
Perani
F
F
Grassi
S
S
Bressi
S
S
Amadio
M
M
Antoni
G C
GC
Comi
N
N
Canal
F
F
Fazio
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism*; D001931:Brain Mapping; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology*; D003847:Deoxyglucose / Q000031:analogs & derivatives / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014055:Tomography, Emission-Computed; D014103:Torticollis / Q000000981:diagnostic imaging* / Q000503:physiopathology
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose