Functional activity of the sensorimotor cortex and cerebellum relates to cervical dystonia symptoms

Roxana G. Burciu, Christopher W. Hess, Stephen A. Coombes, Edward Ofori, Priyank Shukla, Jae Woo Chung, Nikolaus R. McFarland, Aparna Wagle Shukla, Michael S. Okun, David E. Vaillancourt

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Cervical dystonia (CD) is the most common type of focal dystonia, causing abnormal movements of the neck and head. In this study, we used noninvasive imaging to investigate the motor system of patients with CD and uncover the neural correlates of dystonic symptoms. Furthermore, we examined whether a commonly prescribed anticholinergic medication in CD has an effect on the dystonia-related brain abnormalities. Participants included 16 patients with CD and 16 healthy age-matched controls. We collected functional MRI scans during a force task previously shown to extensively engage the motor system, and diffusion and T1-weighted MRI scans from which we calculated free-water and brain tissue densities. The dystonia group was also scanned ca. 2 h after a 2-mg dose of trihexyphenidyl. Severity of dystonia was assessed pre- and post-drug using the Burke–Fahn–Marsden Dystonia Rating Scale. Motor-related activity in CD was altered relative to controls in the primary somatosensory cortex, cerebellum, dorsal premotor and posterior parietal cortices, and occipital cortex. Most importantly, a regression model showed that increased severity of symptoms was associated with decreased functional activity of the somatosensory cortex and increased activity of the cerebellum. Structural imaging measures did not differ between CD and controls. The single dose of trihexyphenidyl altered the fMRI signal in the somatosensory cortex but not in the cerebellum. Symptom severity was not significantly reduced post-treatment. Findings show widespread changes in functional brain activity in CD and most importantly that dystonic symptoms relate to disrupted activity in the somatosensory cortex and cerebellum. Hum Brain Mapp 38:4563–4573, 2017.

Original languageEnglish (US)
Pages (from-to)4563-4573
Number of pages11
JournalHuman Brain Mapping
Issue number9
StatePublished - Sep 2017
Externally publishedYes


  • MRI
  • cerebellum
  • cervical dystonia
  • sensorimotor cortex
  • trihexyphenidyl

ASJC Scopus subject areas

  • Anatomy
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology


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