title: Sonographic Alteration of Basal Ganglia in Different Forms of Primary Focal Dystonia: A Cross-sectional Study.
abstract: BACKGROUND
  Few studies have addressed whether abnormalities in the lenticular nucleus (LN) are characteristic transcranial sonography (TCS) echo features in patients with primary dystonia. This study aimed to explore alterations in the basal ganglia in different forms of primary focal dystonia.
  
  
  METHODS
  cross-sectional observational study was performed between December 2013 and December 2014 in 80 patients with different forms of primary focal dystonia and 55 neurologically normal control subjects. TCS was performed in patients and control subjects. Multiple comparisons of multiple rates were used to compare LN hyperechogenicity ratios between control and patient groups.
  
  
  RESULTS
  Thirteen individuals were excluded due to poor temporal bone windows, and two subjects were excluded due to disagreement in evaluation by sonologists. Totally, 70 patients (cervical dystonia, n = 30; blepharospasm, n = 30; oromandibular dystonia, n = 10) and 50 normal controls were included in the final analysis. LN hyperechogenicity was observed in 51% (36/70) of patients with primary focal dystonia, compared with 12% (6/50) of controls (P < 0.001). Substantia nigra hyperechogenicity did not differ between the two groups. LN hyperechogenicity was observed in 73% (22/30) of patients with cervical dystonia, a greater prevalence than in patients with blepharospasm (33%, 10/30, P = 0.002) and oromandibular dystonia (40%, 4/10, P = 0.126). LN hyperechogenicity was more frequently observed in patients with cervical dystonia compared with controls (73% vs. 12%, P < 0.001); however, no significant difference was detected in patients with blepharospasm (33% vs. 12%, P = 0.021) or oromandibular dystonia (40% vs. 12%, P = 0.088).
  
  
  CONCLUSIONS
  LN hyperechogenicity is more frequently observed in patients with primary focal dystonia than in controls. It does not appear to be a characteristic TCS echo feature in patients with blepharospasm or oromandibular dystonia.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China.
authors.forename: Ying-Chun
authors.initials: YC
authors.lastname: Zhang
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Sheng
authors.forename: Xiao-Fang
authors.initials: XF
authors.lastname: Chen
authors.forename: Cai-Shan
authors.initials: CS
authors.lastname: Wang
authors.forename: Qi
authors.initials: Q
authors.lastname: Ma
authors.forename: Han-Bing
authors.initials: HB
authors.lastname: Chen
authors.forename: Li-Fang
authors.initials: LF
authors.lastname: Yu
authors.forename: Cheng-Jie
authors.initials: CJ
authors.lastname: Mao
authors.forename: Kang-Ping
authors.initials: KP
authors.lastname: Xiong
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Luo
authors.forename: Chun-Feng
authors.initials: CF
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001764:Blepharospasm / Q000000981:diagnostic imaging; D003342:Corpus Striatum / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D020821:Dystonic Disorders / Q000000981:diagnostic imaging*; D004453:Echoencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged