title: Somatosensory cortical activation in cervical dystonia and its modulation with botulinum toxin: an fMRI study.
abstract: Converging data on focal dystonias suggest a widespread disorder of somatosensory processing. The aims of our study were, first, to assess somatosensory activation patterns in cervical dystonia (CD) beyond the representation of the affected body parts and, second, to search for task-related activation changes induced by botulinum toxin type-A (BoNT-A) therapy. Functional magnetic resonance imaging (MRI) during electrical median nerve stimulation was employed in seven CD patients and nine controls; the examination was repeated 4 weeks after BoNT-A application to dystonic neck muscles. The pretreatment activation map of patients showed activation in the contralateral primary somatosensory cortex, but missing activation in the secondary somatosensory cortex and insula, in contrast to controls and patients after treatment. Clinically significant effect of BoNT-A therapy was associated with a significant increase of BOLD response in the contralateral secondary somatosensory, insular, and inferior parietal cortices. The posttreatment somatosensory maps of patients did not significantly differ from controls. This study has brought evidence of widespread disruption of somatosensory processing in CD and its modification with BoNT-A therapy.
authors.affiliation: Department of Neurology, Palacký University and University Hospital, Olomouc, Czech Republic. robert.opavsky@centrum.cz
authors.forename: Robert
authors.initials: R
authors.lastname: Opavský
authors.forename: Petr
authors.initials: P
authors.lastname: Hluštík
authors.forename: Pavel
authors.initials: P
authors.lastname: Otruba
authors.forename: Petr
authors.initials: P
authors.lastname: Kaňovský
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D011877:Radionuclide Imaging; D013003:Somatosensory Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020886:Somatosensory Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D014103:Torticollis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A