White matter abnormalities in dystonia normalize after botulinum toxin treatment.
The pathophysiology of dystonia is still poorly understood. We used diffusion tensor imaging to screen for white matter abnormalities in regions between the basal ganglia and the thalamus in cervical and hand dystonia patients. All patients exhibited an abnormal hemispheric asymmetry in a focal region between the pallidum and the thalamus. This asymmetry was absent 4 weeks after the same patients were treated with intramuscular botulinum toxin injections. These findings represent a new systems-level abnormality in dystonia, which may lead to new insights about the pathophysiology of movement disorders. More generally, these findings demonstrate central nervous system changes following peripheral reductions in muscle activity. This raises the possibility that we have observed activity-dependent white matter plasticity in the adult human brain.
Blood
Anne J
AJ
Department of Neurology, Massachusetts General Hospital, Charlestown 02129, and Harvard Medical School, Boston, Massachusetts, USA. ablood@nmr.mgh.harvard.edu
Tuch
David S
DS
Makris
Nikos
N
Makhlouf
Miriam L
ML
Sudarsky
Lewis R
LR
Sharma
Nutan
N
D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D001921:Brain / Q000002:abnormalities / Q000187:drug effects / Q000473:pathology; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D020821:Dystonic Disorders / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins