Session Information
Date: Tuesday, September 24, 2019
Session Title: Dystonia
Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: Aim of this study is to compare the response of sensorimotor networks to botulinum toxin (BoNT) therapy in naïve and repeatedly-treated CD patients.
Background: BoNT injections are currently the most effective, although symptomatic, treatment of focal dystonia. Clinical effect of BoNT on dystonia is assumed to be mediated by dynamic changes at multiple levels of the sensorimotor system, from the neuromuscular junction up to the cerebral cortex. Although the first BoNT injection is effective, the clinical picture in cervical dystonia (CD) often changes during continuous BoNT treatment. This results in some cases in the need to change the BoNT injection pattern by clinicians.
Method: Six CD patients were examined with whole-brain functional MRI during electrical stimulation of the median nerve at the wrist and during a skilled hand motor task before and 4 weeks after the BoNT-A injection to the dystonic neck muscles. The first pair of these examinations was performed before and after the first BoNT-A injection. Next pair was performed in the same subjects after 5 years of regular and effective BoNT-A treatment.
Results: In electrical stimulation, effective BoNT-A treatment resulted in differential response to somatosensory stimulation in the contralateral precentral and postcentral gyrus. The first BoNT-A injection led to activation increase in all subjects, whereas the activation decreased after BoNT-A injection in long-term treatment.
Conclusion: Differential response to electrical stimulation may reflect gradual changes in sensorimotor integration during continuous BoNT-A treatment. In agreement with sustained good clinical outcome, changes in hand motor related activation remained stable throughout the follow-up.Research supported by the grant of the Agency for Healthcare Research of Ministry of Health of the Czech Republic (AZV MZ ČR) 16-30210A and Institutional Support of Research Organization MZ CR RV FNOL 2018. All rights reserved.
To cite this abstract in AMA style:
M. Nevrly, P. Hlustik, P. Hok, M. Kaiserova, P. Otruba, Z. Tudos, P. Kanovsky. Differences in botulinum toxin long-term treated and non-treated cervical dystonia patients in somatosensory task-related functional imaging response. [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/differences-in-botulinum-toxin-long-term-treated-and-non-treated-cervical-dystonia-patients-in-somatosensory-task-related-functional-imaging-response/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/differences-in-botulinum-toxin-long-term-treated-and-non-treated-cervical-dystonia-patients-in-somatosensory-task-related-functional-imaging-response/