RSFC; rTMS; rsfMRI; sensory motor network; writer's cramp; Adult; Brain/physiopathology; Connectome/methods; Dystonic Disorders/physiopathology; Dystonic Disorders/therapy; Hand/physiopathology; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nerve Net/physiopathology; Transcranial Magnetic Stimulation/methods; Treatment Outcome; Young Adult; Brain; Connectome; Dystonic Disorders; Hand; Nerve Net; Transcranial Magnetic Stimulation; Neurology; Neurology (clinical)
Abstract :
[en] ("[en] BACKGROUND AND PURPOSE: Writer's cramp (WC) is a focal task-specific dystonia of the hand which is increasingly being accepted as a network disorder. Non-invasive cortical stimulation using repetitive transcranial magnetic stimulation (rTMS) has produced therapeutic benefits in some of these patients. This study aimed to visualize the motor network abnormalities in WC and also its rTMS induced modulations using resting state functional magnetic resonance imaging (rsfMRI).
METHODS: Nineteen patients with right-sided WC and 20 matched healthy controls (HCs) were prospectively evaluated. All patients underwent a single session of rTMS and rsfMRI was acquired before (R1) and after (R2) rTMS. Seed-based functional connectivity analysis of several regions in the motor network was performed for HCs, R1 and R2 using SPM8 software. Thresholded (P < 0.05, false discovery rate corrected) group level mean correlation maps were used to derive significantly connected region of interest pairs.
RESULTS: Writer's cramp showed a significant reduction in resting state functional connectivity in comparison with HCs involving the left cerebellum, thalamus, globus pallidus, putamen, bilateral supplementary motor area, right medial prefrontal lobe and right post central gyrus. After rTMS there was a significant increase in the contralateral resting state functional connectivity through the left thalamus-right globus pallidus-right thalamus-right prefrontal lobe network loop.
CONCLUSIONS: It is concluded that WC is a network disorder with widespread dysfunction much larger than clinically evident and changes induced by rTMS probably act through subcortical and trans-hemispheric unaffected connections. Longitudinal studies with therapeutic rTMS will be required to ascertain whether such information could be used to select patients prior to rTMS therapy.","[en] ","")
Disciplines :
Neurology
Author, co-author :
Bharath, R D; Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Biswal, B B; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, United States
Bhaskar, M V; Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Gohel, S; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, United States
Jhunjhunwala, K; Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Panda, Rajanikant ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
George, L; Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Gupta, A K; Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Pal, P K; Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
Language :
English
Title :
Repetitive transcranial magnetic stimulation induced modulations of resting state motor connectivity in writer's cramp.
Defazio G, Berardelli A, Hallett M. Do primary adult-onset focal dystonias share aetiological factors? Brain 2007; 130: 1183-1193.
Hallett M. Pathophysiology of writer's cramp. Hum Mov Sci 2006; 25: 454-463.
Quartarone A, Hallett M. Emerging concepts in the physiological basis of dystonia. Mov Disord 2013; 28: 958-967.
Hallett M. Neurophysiology of dystonia: the role of inhibition. Neurobiol Dis 2011; 42: 177-184.
Perlmutter JS, Mink JW. Dysfunction of dopaminergic pathways in dystonia. Adv Neurol 2004; 94: 163.
Segawa M. Dopa-responsive dystonia. Handb Clin Neurol 2010; 100: 539-557.
Tabbal S, Mink J, Antenor J, Carl J, Moerlein S, Perlmutter J. 1-Methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine-induced acute transient dystonia in monkeys associated with low striatal dopamine. Neuroscience 2006; 141: 1281-1287.
Levy LM, Hallett M. Impaired brain GABA in focal dystonia. Ann Neurol 2002; 51: 93-101.
Candia V, Elbert T, Altenmüller E, Rau H, Schäfer T, Taub E. Constraint-induced movement therapy for focal hand dystonia in musicians. Lancet 1999; 353: 42.
Byl NN, Archer ES, McKenzie A. Focal hand dystonia: effectiveness of a home program of fitness and learning-based sensorimotor and memory training. J Hand Ther 2009; 22: 183-198.
Delnooz C, Helmich RC, Medendorp W, Van de Warrenburg BP, Toni I. Writer's cramp: increased dorsal premotor activity during intended writing. Hum Brain Mapp 2013; 34: 613-625.
Castrop F, Dresel C, Hennenlotter A, Zimmer C, Haslinger B. Basal ganglia-premotor dysfunction during movement imagination in writer's cramp. Mov Disord 2012; 27: 1432-1439.
de Vries PM, Johnson KA, de Jong BM, et al. Changed patterns of cerebral activation related to clinically normal hand movement in cervical dystonia. Clin Neurol Neurosurg 2008; 110: 120-128.
Huang YZ, Rothwell JC, Lu CS, Wang J, Chen RS. Restoration of motor inhibition through an abnormal premotor-motor connection in dystonia. Mov Disord 2010; 25: 696-703.
Islam T, Kupsch A, Bruhn H, Scheurig C, Schmidt S, Hoffmann K-T. Decreased bilateral cortical representation patterns in writer's cramp: a functional magnetic resonance imaging study at 3.0 T. Neurol Sci 2009; 30: 219-226.
Preibisch C, Berg D, Hofmann E, Solymosi L, Naumann M. Cerebral activation patterns in patients with writer's cramp: a functional magnetic resonance imaging study. J Neurol 2001; 248: 10-17.
Nelson AJ, Blake DT, Chen R. Digit-specific aberrations in the primary somatosensory cortex in writer's cramp. Ann Neurol 2009; 66: 146-154.
Meunier S, Garnero L, Ducorps A, et al. Human brain mapping in dystonia reveals both endophenotypic traits and adaptive reorganization. Ann Neurol 2001; 50: 521-527.
Delmaire C, Vidailhet M, Elbaz A, et al. Structural abnormalities in the cerebellum and sensorimotor circuit in writer's cramp. Neurology 2007; 69: 376-380.
Delmaire C, Vidailhet M, Wassermann D, et al. Diffusion abnormalities in the primary sensorimotor pathways in writer's cramp. Arch Neurol 2009; 66: 502-508.
Vitek JL, Chockkan V, Zhang JY, et al. Neuronal activity in the basal ganglia in patients with generalized dystonia and hemiballismus. Ann Neurol 1999; 46: 22-35.
Chen R, Wassermann EM, Caños M, Hallett M. Impaired inhibition in writer's cramp during voluntary muscle activation. Neurology 1997; 49: 1054-1059.
Münchau A, Schrag A, Chuang C, et al. Arm tremor in cervical dystonia differs from essential tremor and can be classified by onset age and spread of symptoms. Brain 2001; 124: 1765-1776.
Blood AJ. Imaging studies in focal dystonias: a systems level approach to studying a systems level disorder. Curr Neuropharmacol 2013; 11: 3.
Ilmoniemi RJ, Virtanen J, Ruohonen J, Karhu J, Aronen HJ, Katila T. Neuronal responses to magnetic stimulation reveal cortical reactivity and connectivity. Neuroreport 1997; 8: 3537-3540.
Komssi S, Aronen HJ, Huttunen J, et al. Ipsi- and contralateral EEG reactions to transcranial magnetic stimulation. Clin Neurophysiol 2002; 113: 175-184.
Shafi MM, Westover MB, Oberman L, Cash SS, Pascual-Leone A. Modulation of EEG functional connectivity networks in subjects undergoing repetitive transcranial magnetic stimulation. Brain Topogr 2014; 27: 172-191.
Schneider SA, Pleger B, Draganski B, et al. Modulatory effects of 5 Hz rTMS over the primary somatosensory cortex in focal dystonia - an fMRI-TMS study. Mov Disord 2010; 25: 76-83.
Havrankova P, Jech R, Walker ND, et al. Repetitive TMS of the somatosensory cortex improves writer's cramp and enhances cortical activity. Neuro Endocrinol Lett 2010; 31: 73-86.
Delnooz C, Helmich RC, Toni I, van de Warrenburg BP. Reduced parietal connectivity with a premotor writing area in writer's cramp. Mov Disord 2012; 27: 1425-1431.
Dresel C, Haslinger B, Castrop F, Wohlschlaeger AM, Ceballos-Baumann AO. Silent event-related fMRI reveals deficient motor and enhanced somatosensory activation in orofacial dystonia. Brain 2006; 129: 36-46.
Hinkley LB, Webster RL, Byl NN, Nagarajan SS. Neuroimaging characteristics of patients with focal hand dystonia. J Hand Ther 2009; 22: 125-135.
Mohammadi B, Kollewe K, Samii A, Beckmann CF, Dengler R, Münte TF. Changes in resting-state brain networks in writer's cramp. Hum Brain Mapp 2012; 33: 840-848.
Stamelou M, Edwards MJ, Hallett M, Bhatia KP. The non-motor syndrome of primary dystonia: clinical and pathophysiological implications. Brain 2012; 135: 1668-1681.
Van Dijk KR, Sabuncu MR, Buckner RL. The influence of head motion on intrinsic functional connectivity MRI. NeuroImage 2012; 59: 431-438.
Torres-Russotto D, Perlmutter JS. Task-specific dystonias. Ann NY Acad Sci 2008; 1142: 179-199.
Pleger B, Blankenburg F, Bestmann S, et al. Repetitive transcranial magnetic stimulation-induced changes in sensorimotor coupling parallel improvements of somatosensation in humans. J Neurosci 2006; 26: 1945-1952.
Borich M, Arora S, Kimberley TJ. Lasting effects of repeated rTMS application in focal hand dystonia. Restor Neurol Neurosci 2009; 27: 55-65.
