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Perceptual Decision Making in Cervical Dystonia: Development of a a Novel Integrated Neurobehavioural-Neurophysiological Method.

O. Killian, A. Gill, K. Miyauchi, S. Rafee, S. O'Riordan, L. Williams, C. Fearon, R. Reilly (Dublin, Ireland)

Meeting: 2025 International Congress

Keywords: Dystonia: Pathophysiology, Neurophysiology

Category: Dystonia: Disease Mechanisms / Neuroimaging / Neurophysiology

Objective: To investigate perceptual decision-making (PDM) in cervical dystonia (CD) using a novel paradigm and determine the neural basis of PDM abnormalities in a CD cohort.

Background: Cervical Dystonia is a movement disorder characterized by abnormal neck posturing. Non-motor features such as anxiety are prominent in CD. Increasing evidence suggests CD is a network disorder with both sensory and motor abnormalities. Prior studies have linked the superior colliculus (SC) to CD pathophysiology and abnormalities in temporal discrimination. It is unknown whether these findings relate to sensory processing alone or downstream perceptual decision making (PDM). This study seeks to investigate PDM performance and its neural correlates in a CD cohort.

Method: Seven CD patients and six age-matched healthy controls completed a dynamic translational Glass pattern task. Simultaneously, 24-channel EEG recordings were obtained to assess centro-parietal positivity (CPP), a neural correlate of PDM. The Glass pattern task was performed at 4 fixed levels of coherence to assess PDM. Reaction time (RT), accuracy and CPP  were analyzed to assess between-group differences. Baseline impulsivity was assessed using the Eriksen Flanker task. Cognitive (MOCA), mood (BDI) and anxiety (BAI) assessments were conducted prior to testing.

Results: No significant difference in RT or accuracy was found between the groups. However, the control group showed a significant correlation between RT and CPP peak amplitude (R2=0.9867), whereas the CD group demonstrated no correlation between RT and CPP amplitude (R2=0.013).

Conclusion: CD patients exhibit altered neural metrics of PDM despite intact behavioural performance. CD patients may achieve this comparable performance through alternative or compensatory mechanisms. Further investigation with a larger sample size and using additional methods is required to confirm this finding. PDM abnormalities should be assessed in other forms of adult-onset isolated focal dystonia and other disorders that exhibit temporal discrimination abnormalities. These findings suggest CPP may serve as a novel endophenotypic marker for CD.

To cite this abstract in AMA style:

O. Killian, A. Gill, K. Miyauchi, S. Rafee, S. O'Riordan, L. Williams, C. Fearon, R. Reilly. Perceptual Decision Making in Cervical Dystonia: Development of a a Novel Integrated Neurobehavioural-Neurophysiological Method. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/perceptual-decision-making-in-cervical-dystonia-development-of-a-a-novel-integrated-neurobehavioural-neurophysiological-method/. Accessed October 5, 2025.
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