Objective: To assess the susceptibility-weighted imaging in patients with idiopathic cervical dystonia

Background: Susceptibility-weighted imaging (SWI) is an advanced MR imaging sequence that can be implemented at routine MRI imaging and is very sensitive to mineralization. Basal ganglia may exhibit increased susceptibility to mineralization because of their high metabolic rate. The SWI has been indeed used in patients with Parkinson´s disease and Parkinson-plus disorders for diagnostic and differential diagnostic purposes. Cervical dystonia is generally perceived to be a network disorder but the evidence about discrete structural changes of brain is rising.

Method: We enrolled 22 patients with idiopathic cervical dystonia with mean age 55,5 years (STD=8,3), mean disease duration 9 years (STD=6) and mean Toronto Western Spasmodic Torticollis Rating Scale score was 43,2 points (STD=12,4). All patients underwent brain MRI in the window of 4-8 weeks after botulinum toxin application to minimise the movement artefacts. Twenty age- and education-matched healthy controls were also included. Using SWI, ten regions of interest with the main focus on basal ganglia were visually assessed by an experienced radiologist blinded to the subject data.

Results: We documented increased mineralization (SWI hypointensities) in the putamen in 13 (59%) out of 22 patients with CD. Only 2 healthy controls had SWI hypointensities. Patients with SWI positive findings did not have different age, disease duration or clinical impairment when compared with SWI absent participants.

Conclusion: To our knowledge, this is the first study to claim the positive SWI findings in patients with cervical dystonia. Practical implications remain to be elucidated.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-increased-mineralisation-of-putamen-relevant-for-pathophysiology-of-cervical-dystonia/