title: Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias.
abstract: Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia.
  
  
  
  We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM) to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7). We used (1) automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2) blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume); and (3) voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus.
  
  
  
  Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region.
  
  
  
  Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches.
authors.affiliation: Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.|Division of Child Neurology, Boston Children's Hospital, Boston, MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Waugh
authors.affiliation: Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America.|Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: John K
authors.initials: JK
authors.lastname: Kuster
authors.affiliation: Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Levenstein
authors.affiliation: Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.|Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: Nikos
authors.initials: N
authors.lastname: Makris
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.
authors.forename: Trisha J
authors.initials: TJ
authors.lastname: Multhaupt-Buell
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.
authors.forename: Lewis R
authors.initials: LR
authors.lastname: Sudarsky
authors.affiliation: Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America.|Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.|Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: Hans C
authors.initials: HC
authors.lastname: Breiter
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.|Department of Neurology, Brigham and Women's Hospital, Boston MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.
authors.forename: Nutan
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Mood and Motor Control Laboratory, Massachusetts General Hospital, Charlestown, MA, United States of America.|Laboratory of Neuroimaging and Genetics, Massachusetts General Hospital, Charlestown, MA, United States of America.|Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.|Harvard Medical School, Boston, MA, United States of America.|Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, MA, United States of America.
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Blood
mesh_terms: D003710:Demography; D005260:Female; D006801:Humans; D007830:Larynx / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D013788:Thalamus / Q000473:pathology*; D014103:Torticollis / Q000473:pathology*