In cervical dystonia, functional MRI (fMRI) evidence indicates changes in several resting state networks, which revert in part following the botulinum neurotoxin A (BoNT) therapy. Recently, the involvement of the cerebellum in dystonia has gained attention. The aim of our study was to compare connectivity between cerebellar subdivisions and the rest of the brain before and after BoNT treatment. Seventeen patients with cervical dystonia indicated for treatment with BoNT were enrolled (14 female, aged 50.2 ± 8.5 years, range 38-63 years). Clinical and fMRI examinations were carried out before and 4 weeks after BoNT injection. Clinical severity was evaluated using TWSTRS. Functional MRI data were acquired on a 1.5 T scanner during 8 min rest. Seed-based functional connectivity analysis was performed using data extracted from atlas-defined cerebellar areas in both datasets. Clinical scores demonstrated satisfactory BoNT effect. After treatment, connectivity decreased between the vermis lobule VIIIa and the left dorsal mesial frontal cortex. Positive correlations between the connectivity differences and the clinical improvement were detected for the right lobule VI, right crus II, vermis VIIIb and the right lobule IX. Our data provide evidence for modulation of cerebello-cortical connectivity resulting from successful treatment by botulinum neurotoxin.

Department of Computer Science Faculty of Science of Palacký University Olomouc Olomouc Czech Republic

Department of Neurology Faculty of Medicine and Dentistry of Palacký University Olomouc Olomouc Czech Republic

Department of Neurology University Hospital Olomouc 1 P Pavlova 6 77900 Olomouc Czech Republic

Department of Radiology Faculty of Medicine and Dentistry of Palacký University Olomouc Olomouc Czech Republic

Department of Radiology University Hospital Olomouc Olomouc Czech Republic

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The Central Effects of Botulinum Toxin in Dystonia and Spasticity