BACKGROUND: The evidence suggests that the origin of primary dystonia is at least partly associated with widespread dysfunction of the basal ganglia and cortico-striato-thalamo-cortical circuits. The aim of the study was to assess the sensorimotor activation pattern outside the circuits controlling the affected body part in cervical dystonia, as well as to determine task-related activation changes induced by botulinum toxin type A (BoNT-A) treatment. METHODS: Seven patients suffering from cervical dystonia and nine healthy controls were examined with functional MRI during skilled hand motor task; the examination was repeated 4 weeks after BoNT-A application to dystonic neck muscles. RESULTS: Functional MRI data demonstrated overall reduced extent of hand movement-related cortical activation but greater magnitude of blood oxygenation level dependent signal change in the contralateral secondary somatosensory cortex in patients compared to controls. Effective BoNT-A treatment led to reduced activation of the ipsilateral supplementary motor area and dorsal premotor cortex in patients. The patients' post-treatment sensorimotor maps showed significantly smaller basal ganglia activation compared to controls. CONCLUSIONS: These results provide imaging evidence that abnormalities in sensorimotor activation extend beyond circuits controlling the affected body parts in cervical dystonia. The study also supports observations that BoNT-A effect has a correlate at central nervous system level, and such effect may not be limited to cortical and subcortical representations of the treated muscles.

• MeSH
• analýza rozptylu MeSH
• botulotoxiny typ A terapeutické užití   MeSH
• dospělí MeSH
• krční svaly patofyziologie   MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mapování mozku MeSH
• nervosvalové látky terapeutické užití   MeSH
• nervové dráhy krevní zásobení   fyziologie   MeSH
• počítačové zpracování obrazu metody   MeSH
• somatosenzorické korové centrum krevní zásobení   účinky léků   MeSH
• tortikolis farmakoterapie   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH

Parkinson's disease (PD) affects speech, including respiration, phonation, and articulation. We measured the blood oxygen level-dependent (BOLD) response to overt sentence reading in: (1) 9 treated female patients with mild to moderate PD (age; mean 66.0 +/- 11.6 years, mean levodopa equivalent 583.3 +/- 397.9 mg) and (2) 8 age-matched healthy female controls (age; mean 62.2 years +/- 12.3). Speech was recorded in the scanner to assess which brain regions underlie variations in the initiation and paralinguistic aspects (e.g., pitch, loudness, and rate) of speech production in the two groups. There were no differences in paralinguistic aspects of speech except for speech loudness; it was lower in PD patients compared with that in controls, when age was used as a covariate. In both groups, we observed increases in the BOLD response (reading-baseline) in brain regions involved in speech production and perception. In PD patients, as compared with controls, we found significantly higher BOLD signal in the right primary orofacial sensorimotor cortex and more robust correlations between the measured speech parameters and the BOLD response to reading, particularly, in the left primary orofacial sensorimotor cortex. These results might reflect compensatory mechanisms and/or treatment effects that take place in mild to moderately ill PD patients with quality of speech yet comparable with that of age-matched controls. (c) 2007 Movement Disorder Society.

• MeSH
• akustická stimulace metody   MeSH
• akustika řeči MeSH
• financování organizované MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mapování mozku MeSH
• Parkinsonova nemoc patologie   patofyziologie   MeSH
• počítačové zpracování obrazu metody   MeSH
• řeč fyziologie   MeSH
• senioři MeSH
• somatosenzorické korové centrum krevní zásobení   patofyziologie   MeSH
• statistika jako téma MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH

Rapid-rate transcranial magnetic stimulation (rTMS) was used to stimulate the primary sensorimotor cortex in six healthy volunteers while regional changes in cerebral blood flow (CBF) were simultaneously measured by means of positron emission tomography. A figure-eight TMS coil (Cadwell Corticoil) was positioned, using frameless stereotaxy, over the probabilistic location of the left primary sensorimotor cortex, and a series of brief 10-Hz trains of TMS was delivered at subthreshold intensity during each of six 60-s scans. The scans differed in the number of trains delivered, namely 5, 10, 15, 20, 25, and 30 trains/scan, respectively. In the left primary sensorimotor cortex, CBF covaried significantly and negatively with the number of stimulus trains. These CBF decreases may reflect TMS-induced activation of local inhibitory mechanisms known to play a role in TMS-related phenomena, such as the electromyographic silent period.

• MeSH
• dospělí MeSH
• elektromyografie MeSH
• lidé MeSH
• motorické korové centrum * krevní zásobení   MeSH
• mozkový krevní oběh * MeSH
• ruka fyziologie   MeSH
• somatosenzorické korové centrum * krevní zásobení   MeSH
• tomografie emisní počítačová MeSH
• transkraniální magnetická stimulace * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH