Exploratory structural assessment in craniocervical dystonia: Global and differential analyses

Area of Science:

• Neuroscience
• Neurology
• Medical Imaging

Background:

• Craniocervical dystonia (CD) encompasses various forms, including cervical dystonia (CeD) and blepharospasm/oromandibular dystonia (B/OMD).
• Understanding the neuroanatomical underpinnings of CD subtypes is crucial for targeted therapeutic strategies.

Purpose of the Study:

• To investigate differences in cortical thickness and subcortical volume in individuals with CD and its specific subgroups compared to healthy controls.
• To explore the relationship between neuroanatomical findings and clinical features within CD patients.

Main Methods:

• Utilized Freesurfer software for comprehensive analysis of cortical thickness and subcortical volumes in 49 CD patients (17 CeD, 18 B/OMD) and 79 controls.
• Performed whole-group and subgroup analyses, including region of interest and exploratory generalized linear modeling with clinical features.

Main Results:

• Craniocervical dystonia showed atrophy in visual processing regions.
• Cervical dystonia exhibited atrophy in motor, sensory, and limbic regions, with greater frontal pole and medial orbitofrontal cortical thickness compared to B/OMD.
• Blepharospasm/oromandibular dystonia displayed atrophy in motor, sensory, and visual areas.

Conclusions:

• Confirmed involvement of visual processing regions in CD, with distinct patterns in CeD and B/OMD affecting motor, sensory, and limbic areas.
• Cortical atrophy was associated with younger onset age, older MRI age, and higher clinical scores, with an unclear link to botulinum toxin duration.