Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To present i) imaging data in a case of hemidystonia using structural (diffusion tensor imaging-DTI and fiber tractography-FT) and functional (functional MRI-fMRI and magnetoencephalography-MEG) diagnostic modalities, and ii) one year outcomes of unilateral pallidal deep brain stimulation (DBS).
Background: Since dystonia syndromes arise from multiple etiologies, study of hemi-involvement potentially can offer insights into its pathophysiology. With neuroimaging techniques such as fMRI and magnetic electroencephalography (MEG), pathway connectivity can be studied for a better understanding of dystonia mechanisms. We present a DBS-treated hemi-dystonia patient whose studies provide a multi-regional view of dystonia’s impact.
Methods: After 10 years of left axial hemidystonia, a 45 year-old male underwent GPi DBS. Whole brain MEG pre- and post-anticholinergic medication as well as post-medication fMRI and 26-direction DTI/FT were obtained in a 3T MRI machine. The patient was assessed pre- and one year post-surgery using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS).
Results: fMRI revealed strong ipsi- and contralateral connectivity of both motor thalami with the primary motor, sensory and pre-motor cortex. DTI and FT demonstrated stronger ipsilateral connectivity for the motor thalamus, dentate nucleus and globus pallidus internus for the left hemisphere compared to the right. MEG showed a reduction in the high coherence seen bilaterally in the motor areas post treatment (with eyes open). In the eyes closed MEG study there was an increase in brain coherence in the gamma band post-medication in the middle and inferior frontal region. With DBS treatment, BFMDRS motor and disability scores dropped by 71%.
Conclusions: Advanced multimodal neuroimaging techniques can offer insights into the pathophysiology of dystonia and can direct choices for developing therapeutics. Unilateral pallidal DBS can provide significant symptom control in axial hemidystonia poorly responsive to medication.
To cite this abstract in AMA style:C. Sidiropoulos, S. Bowyer, A. Zillgitt, P.A. LeWitt, H. Bagher-Ebadian, E. Davoodi-Bojd, J.M. Schwalb, H. Soltanian-Zadeh. Multi-parameter imaging in hemidystonia responsive to GPi deep brain stimulation [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/multi-parameter-imaging-in-hemidystonia-responsive-to-gpi-deep-brain-stimulation/. Accessed September 27, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/multi-parameter-imaging-in-hemidystonia-responsive-to-gpi-deep-brain-stimulation/