Diffusion tensor imaging in pediatric patients with dystonia
Ricardo Loução,
Julia Burkhardt,
Jochen Wirths,
Christoph Kabbasch,
Till A. Dembek,
Petra Heiden,
Sebahattin Cirak,
Bassam Al-Fatly,
Harald Treuer,
Veerle Visser-Vandewalle,
Mauritius Hoevels,
Anne Koy
Affiliations
Ricardo Loução
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany; Department of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Corresponding author at: Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany.
Julia Burkhardt
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany
Jochen Wirths
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany
Christoph Kabbasch
Department of Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Till A. Dembek
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Petra Heiden
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany; Department of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Sebahattin Cirak
Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Bassam Al-Fatly
Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Harald Treuer
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany
Veerle Visser-Vandewalle
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany
Mauritius Hoevels
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, Cologne 50937, Germany
Anne Koy
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Background: Childhood-onset dystonia is often progressive and severely impairs a child´s life. The pathophysiology is very heterogeneous and treatment responses vary in patients with dystonia. Factors influencing treatment effects remain to be elucidated. We hypothesize that differences in brain connectivity and fiber coherence contribute to the heterogeneity in treatment response among pediatric patients with inherited and acquired dystonia.Methods: Twenty patients with childhood-onset dystonia were retrospectively recruited including twelve patients with inherited or idiopathic, and eight patients with acquired dystonia (mean age 10 years; 8 female/12 male). Fiber density between the internal part of the globus pallidus and selective target regions, as well as the diffusion measures of fractional anisotropy (FA) and mean diffusivity (MD) were analyzed and compared between different etiologies.Results: Patients with acquired dystonia presented higher fiber density to the premotor cortex and putamen and lower FA values in the thalamus compared to patients with inherited/idiopathic dystonia. MD in the premotor cortex was higher in patients with acquired dystonia, while it was lower in the thalamus.Conclusion: Diffusion MRI reveals microstructural and network alterations in patients with dystonia of different etiologies.
