Diffusion abnormalities in the primary sensorimotor pathways in writer's cramp.
OBJECTIVE
To determine whether there are diffusion abnormalities along the fibers connecting sensorimotor regions, including the primary sensorimotor areas and the striatum, in patients with writer's cramp using voxel-based diffusion analysis and fiber tracking. Recent studies have shown structural changes in these regions in writer's cramp.


METHODS
Patient and control group comparison.


METHODS
Referral center for movement disorders.


METHODS
Twenty-six right-handed patients with writer's cramp and 26 right-handed healthy control subjects matched for sex and age.


METHODS
Clinical motor evaluations.


METHODS
Fractional anisotropy changes and results of fiber tracking in writer's cramp.


RESULTS
Diffusion-tensor imaging revealed increased fractional anisotropy bilaterally in the white matter of the posterior limb of the internal capsule and adjacent structures in the patients with writer's cramp. Fiber tracking demonstrated that fractional anisotropy changes involve fiber tracts connecting the primary sensorimotor areas with subcortical structures.


CONCLUSIONS
Diffusion abnormalities are present in fiber tracts connecting the primary sensorimotor areas with subcortical structures in writer's cramp. These abnormalities strengthen the role of the corticosubcortical pathways in the pathophysiologic mechanisms of writer's cramp.
Department of Neuroradiology, Centre Hospitalier Régional Universitaire Roger Salengro, Lille, France.
Christine
C
Delmaire
Marie
M
Vidailhet
Demian
D
Wassermann
Maxime
M
Descoteaux
Romain
R
Valabregue
Frédéric
F
Bourdain
Christophe
C
Lenglet
Sophie
S
Sangla
Axel
A
Terrier
Rachid
R
Deriche
Stéphane
S
Lehéricy
D000328:Adult; D000368:Aged; D016880:Anisotropy; D016022:Case-Control Studies; D003342:Corpus Striatum / Q000473:pathology / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D020821:Dystonic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020772:Internal Capsule / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology*; D009413:Nerve Fibers, Myelinated / Q000502:physiology; D009460:Neurologic Examination; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology; D013003:Somatosensory Cortex / Q000473:pathology / Q000503:physiopathology*; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult