Objective: To characterize white matter integrity in the striatum and pedunculopontine nucleus (PPN) in patients with cervical dystonia using diffusion tensor imaging (DTI).

Background: The etiology of primary cervical dystonia is unknown. There is evidence for striatal and PPN abnormalities in human neuropathology studies and animal models of dystonia along with imaging abnormalities in the striatum in patients with primary dystonia. There may be altered white matter integrity in the striatum and the PPN.

Methods: 7 patients with primary cervical dystonia and 8 healthy controls without neurological or psychiatric disorders underwent 3T MRI scanning with acquisitions of T1, T2, and DTI sequences. Tolerably Obsessive Registration and Tensor Optimization Indolent Software Ensemble (TORTOISE) software was used for DTI processing, including eddy current correction and tensor calculations. Manual segmentation was performed for the PPN, and automated segmentation was performed for the other regions of interest, caudate nucleus and putamen. Statistical significance is defined as p<0.05.

Results: The mean age of cervical dystonia patients was 48.3 +/- 10.8 years; the mean age of healthy controls was 50.0 +/- 11.1 years. Mean fractional anisotropy (FA) of the caudate, putamen, and PPN were 0.268 +/- 0.054, 0.378 +/- 0.050, and 0.0945 +/- 0.022, respectively, for the cervical dystonia group, and 0.285 +/- 0.053, 0.395 +/- 0.045, and 0.106 +/- 0.042, respectively, for the control group. While there are slightly lower FA values in the cervical dystonia group, there were no statistically significant differences in the FA values between the groups.

Conclusions: In this small study, no statistically significant differences in white matter integrity in the striatum and PPN between cervical dystonia patients and healthy controls were identified by DTI. A study with a larger sample size and tractography would be necessary to explore the lower FA values in cervical dystonia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/striatal-and-pedunculopontine-nucleus-diffusion-tensor-imaging-in-cervical-dystonia/