Diffusion abnormalities in the primary sensorimotor pathways in writer's cramp.

Archives of neurology

PubMedID: 19364935

Delmaire C, Vidailhet M, Wassermann D, Descoteaux M, Valabregue R, Bourdain F, Lenglet C, Sangla S, Terrier A, Deriche R, Lehéricy S. Diffusion abnormalities in the primary sensorimotor pathways in writer's cramp. Arch Neurol. 2009;66(4):502-8.
OBJECTIVE
To determine whether there are diffusion abnormalities along the fibers connecting sensorimotor regions, including the primary sensorimotor areas and the striatum, in patients with writer's cramp using voxel-based diffusion analysis and fiber tracking. Recent studies have shown structural changes in these regions in writer's cramp.

DESIGN
Patient and control group comparison.

SETTING
Referral center for movement disorders.

PARTICIPANTS
Twenty-six right-handed patients with writer's cramp and 26 right-handed healthy control subjects matched for sex and age.

INTERVENTIONS
Clinical motor evaluations.

MAIN OUTCOME MEASURES
Fractional anisotropy changes and results of fiber tracking in writer's cramp.

RESULTS
Diffusion-tensor imaging revealed increased fractional anisotropy bilaterally in the white matter of the posterior limb of the internal capsule and adjacent structures in the patients with writer's cramp. Fiber tracking demonstrated that fractional anisotropy changes involve fiber tracts connecting the primary sensorimotor areas with subcortical structures.

CONCLUSIONS
Diffusion abnormalities are present in fiber tracts connecting the primary sensorimotor areas with subcortical structures in writer's cramp. These abnormalities strengthen the role of the corticosubcortical pathways in the pathophysiologic mechanisms of writer's cramp.