Objective: This study focused on grey matter changes in the cerebellum by performing voxel-based morphometry (VBM) on infratentorial MRI scans of writers’ cramp (WC) patients, using tools designed and sensitive to detect cerebellar changes.

Background: WC is a rare disorder that leads to uncontrolled muscle contractions during writing. Previous studies in WC patients targeting cerebellar changes in the grey matter have shown ambivalent results. VBM was usually performed in a whole brain analysis.

Method: Thirty right-handed WC patients, 20 of whom were diagnosed with complex WC, and 27 healthy controls were studied.  The spatially unbiased infratentorial template toolbox (SUIT) was used to extract the infratentorial parts of the brain from MRI data and grey matter separation was performed using CAT12.

Results: WC patients showed increased grey matter volume compared to healthy controls (7 clusters, size: 26 – 169 voxels, predominantly in the right cerebellar hemisphere). This was confirmed in simple WC (1 cluster, size: 117 voxels, right cerebellar hemisphere) and complex WC (5 clusters, size: 32 – 462 voxels, right cerebellar hemisphere) subgroups. In the literature, cluster locations are attributed to motor and non-motor areas. The largest clusters are assigned to the frontoparietal network (modulation of brain areas for rapid goal-directed performance), followed by the ventral attention network and partially the dorsal attention and somatomotor networks.

Conclusion: The increase in grey matter volume in WC patients in the ipsilateral hemisphere suggests a compensatory cerebellar function to cope with the disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/increased-cerebellar-grey-matter-in-writers-cramp-patients-a-morphometric-signature-of-symptom-compensation/