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Published on: February 23, 2020
Functional MRI connectivity of the primary motor cortex in functional dystonia patients
Noemi Piramide1,2, Elisabetta Sarasso1, Aleksandra Tomic3
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Background:
Functional movement disorders include a wide spectrum of clinically documented movement disorders without an apparent organic substrate.
Objective:
To explore the functional connectivity (FC) of the primary motor (M1) cortex in functional dystonia (FD) patients relative to healthy controls, with a focus on different clinical phenotypes.
Methods:
Forty FD patients (12 fixed [FixFD]; 28 mobile [MobFD]) and 43 healthy controls (14 young FixFD-age-matched [yHC]; 29 old MobFD-age-matched [oHC]) underwent resting state fMRI. A seed-based FC analysis was performed using bilateral M1 as regions of interest.
Results:
Compared to controls, FD patients showed reduced FC between left M1 and left dorsal anterior cingulate cortex, and between right M1 and left M1, premotor/supplementary motor area (SMA), dorsal posterior cingulate cortex (PCC), and bilateral precuneus. Relative to yHC, FixFD patients showed reduced FC between M1 and precuneus bilaterally. Compared to oHC, MobFD patients revealed reduced FC between right M1 and left M1, premotor/SMA, dorsal-PCC, bilateral primary sensory cortices and parieto-occipital areas, and increased FC of right M1 with right associative visual cortex and bilateral ventral-PCC. FixFD patients, relative to MobFD, showed lower FC between the right M1 and right associative visual area, and bilateral precuneus and ventral-PCC.
Conclusions:
This study suggests an altered brain FC of the motor circuit with areas involved in emotional processes and sense of agency in FD. FixFD patients showed FC abnormalities mainly in areas related to sense of agency, while MobFD in regions involved in sensorimotor functions (reduced FC) and emotional processing (increased FC).
Insights
Functional dystonia (FD) is linked to altered brain functional connectivity (FC) in motor circuits. Fixed FD shows reduced FC in sense of agency areas, while mobile FD shows altered sensorimotor and emotional processing connectivity.
Area of Science:
- Neuroscience
- Neurology
- Functional Movement Disorders
Background:
- Functional movement disorders (FMDs) encompass a range of conditions lacking an identifiable organic cause.
- Functional dystonia (FD) is a subtype of FMD characterized by involuntary muscle contractions.
Purpose of the Study:
- To investigate functional connectivity (FC) alterations in the primary motor (M1) cortex in patients with functional dystonia (FD).
- To compare FC patterns between different clinical phenotypes of FD (fixed vs. mobile) and healthy controls.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) was used in 40 FD patients and 43 healthy controls.
- Seed-based FC analysis focused on bilateral M1 regions of interest.
- Participants included fixed FD (FixFD), mobile FD (MobFD), young healthy controls (yHC), and older healthy controls (oHC).
Main Results:
- FD patients exhibited reduced FC between M1 and areas like the dorsal anterior cingulate cortex, SMA, PCC, and precuneus compared to controls.
- FixFD patients showed reduced M1-precuneus FC relative to yHC.
- MobFD patients displayed altered FC in sensorimotor and visual areas, with both reduced and increased connectivity patterns compared to oHC.
Conclusions:
- Altered brain functional connectivity in motor circuits, involving emotional processing and sense of agency networks, is implicated in FD.
- Distinct FC abnormalities were observed between fixed and mobile FD phenotypes, suggesting different underlying neural mechanisms.
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