Exploratory structural assessment in craniocervical dystonia: Global and differential analyses

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Vilany, Larissa ; de Rezende, Thiago J. R. ; Piovesana, Luiza G. ; Campos, Lidiane S. ; de Azevedo, Paula C. ; Torres, Fabio R. ; Franca, Jr., Marcondes C. ; Amato-Filho, Augusto C. ; Lopes-Cendes, Iscia ; Cendes, Fernando ; D'Abreu, Anelyssa

• Document type: Journal article
• Source: PLoS One; v. 12, n. 8 AUG 22 2017.
• Web of Science Citations: 1

Abstract

Introduction Our goal was to investigate the cortical thickness and subcortical volume in subjects with craniocervical dystonia and its subgroups. Methods We studied 49 subjects, 17 with cervical dystonia, 18 with blepharospasm or oromandibular dystonia, and 79 healthy controls. We performed a whole group analysis, followed by a subgroup analysis. We used Freesurfer software to measure cortical thickness, subcortical volume and to perform a primary exploratory analysis in the craniocervical dystonia group, complemented by a region of interest analysis. We also performed a secondary analysis, with data generated from Freesurfer for subgroups, corrected by false discovery rate. We then performed an exploratory generalized linear model with significant areas for the previous steps using clinical features as independent variables. Results The primary exploratory analysis demonstrated atrophy in visual processing regions in craniocervical dystonia. The secondary analysis demonstrated atrophy in motor, sensory, and visual regions in blepharospasm or oromandibular dystonia, as well as in limbic regions in cervical dystonia. Cervical dystonia patients also had greater cortical thickness than blepharospasm or oromandibular dystonia patients in frontal pole and medial orbitofrontal regions. Finally, we observed an association between precuneus, age of onset of dystonia and age at the MRI exam, in craniocervical dystonia; between motor and limbic regions and age at the exam, clinical score and time on botulinum toxin in cervical dystonia and sensory regions and age of onset and time on botulinum toxin in blepharospasm or oromandibular dystonia. Conclusions We detected involvement of visual processing regions in craniocervical dystonia, and a pattern of involvement in cervical dystonia and blepharospasm or oromandibular dystonia, including motor, sensory and limbic areas. We also showed an association of cortical thickness atrophy and younger onset age, older age at the MRI exam, higher clinical score and an uncertain association with longer time on botulinum toxin. (AU)

• FAPESP's process: 13/07559-3 - BRAINN - The Brazilian Institute of Neuroscience and Neurotechnology
• Grantee: Fernando Cendes
• Support Opportunities: Research Grants - Research, Innovation and Dissemination Centers - RIDC
• FAPESP's process: 13/13270-6 - Analyses of structural changes in primary craniocervical dystonia through the software Freesurfer
• Grantee: Larissa Núbia Nunes Vilany
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 10/11085-9 - Clinical, genetical and neuroimaging evaluation of dystonias in the brazilian population
• Grantee: Anelyssa Cysne Frota D'Abreu
• Support Opportunities: Research Grants - Young Investigators Grants