Prolonged MRI T ₂ times of the lentiform nucleus in idiopathic spasmodic torticollis

Abstract

Using high-field MRI, we investigated possible morphologic changes in the basal ganglia of 22 patients with clinically diagnosed idiopathic spasmodic torticollis (iTs) compared with 28 age-matched normal controls. Two patients were found to have distinct basal ganglia lesions and were excluded from further analysis. The frequency of gross morphologic changes (atrophy, enlarged Virchow-Robin spaces) in patients was not significantly higher than in controls. However, T2 values calculated for the putamen and pallidum on both sides were significantly higher in the lentiform nucleus of the patients compared with the controls. In contrast, other well-defined subcortical regions did not exhibit a similar abnormality, nor did the optical or quantified signal analysis of various regions of interest show any differences. This finding suggests a morphologic abnormality in iTs that is not associated with a gross structural lesion. It could reflect focal gliosis and might correspond to earlier sporadic pathoanatomic descriptions of gliosis in idiopathic dystonia.

Morphometric changes of sensorimotor structures in focal dystonia

“…17,18 Third, high-field MRI data showed prolonged T2 values in the putamen and pallidum of patients with CD supporting the role of these structures in dystonia. 19 Meanwhile, two different positron emission tomography (PET) scan studies using the dopaminergic ligand [18F]spiperone 20 and FDG-PET 21 strongly emphasized the importance of the putamen and thalamus in focal dystonia. Finally, using diffusion tensor imaging MRI techniques, researchers demonstrated changes in the putamen, corpus callosum, pallidum, and caudate in patients with CD.…”

Autonomic cardiovascular function and baroreflex sensitivity in patients with cervical dystonia receiving treatment with botulinum toxin type A

“…Autonomic disturbances are an important component of several basal ganglia diseases [11]. Studies using non-conventional magnetic resonance imaging (MRI) techniques such as volumetric MRI, morphometric MRI (using voxel based morphometry) and diffusion tensor imaging have detected some ultrastructural changes in the striatum, corpus callosum, pallidum, cerebral motor cortex and cerebellar cortex not evident on conventional MRI in CD [3,5,21]. The complex connections of these structures with other basal ganglia and brainstem nuclei could lead to autonomic dysfunction.…”

Symptomatic Dystonias Associated with Structural Brain Lesions: Report of 16 Cases

“…25 The significance of basal ganglia injuries in secondary cervical dystonia has had recent support by the finding of prolonged MRI T 2 times exclusively in the lentiform nucleus in idiopathic spasmodic torticollis. 26 Blepharospasm secondary to structural focal lesions had been described in very few cases, mainly including the lesions of upper brainstem 62728 and, to a lesser degree, bilateral basal ganglia lesions. 29 " 31 An upper brainstem lesion was present in our Patient 15; in our Patient 14, a large tumorous mass primarily' affecting left thalamus and frontoparietal region was found which might also result in brainstem compression and damage.…”