# White matter microstructure in idiopathic craniocervical dystonia

Giordanna a b a Giordanna a b a LS Pinheiro , Rachel RP Guimarães , PT; Luiza GPiovesana , MD; Brunno MCampos , b d a,b BPhys; Lidiane S Campos , MD; Augusto C Amato-Filho ; Marcondes C França Jr , MD, PhD; c a,b a,b Iscia Lopes-Cendes , MD, PhD; Fernando Cendes , MD, PhD; Anelyssa D'Abreu * , MD, PhD, MPH.F. a 2 c d Neuroimaging Laboratory; Department of Neurology; Department of Medical Genetics; Department of Radiology, School of Medical Sciences, University of Campinas, Campinas, Brazil

Introduction: work consisted in evaluating the WM (white matter) microstructure in Introduction: work consisted in evaluating the WM (white matter) microstructure in craniocervical dystonia (CCD) using DTI (diffusion tensor imaging). Dystonia consists in involuntary muscle contractions, causing twisting movements and abnormal postures. CCD involves contractions of head and neck 's muscles. Recent neuroimaging studies have shown the 1-3 involvement of sensorimotor areas and cerebellum in idiopathic dystonia.

Materials and Methods: evaluated 40 patients (59.5±12.3 years-old) and compared than to 40 Materials and Methods: evaluated 40 patients (59.5±12.3 years-old) and compared than to 40 and Methods: healthy controls (56.0±15.0 years-old). Secondarily, we divided the analysis in 4 groups according to dystonia localization: 5 patients with blepharospasm (BSP) (61.8±10.3 years-old), 9 with blepharospasm + oromandibular (BOM) (68.5±5.0 years-old), 8 with blepharospasm + oromandibular + cervical (BOM+ CD) (63.1±11.1 years-old) and 18 with cervical (CD) (52.8±12.2 years-old). MRI images were obtained on a 3T scanner 1-2 weeks after BoNT injections. We performed DTI with TBSS software and obtained fractional anisotropy (FA) and mean diffusivity (MD). We performed two confirmatory analyses: ROI (region of interest) based approach on obtaining the average FA values of all WMvoxels, and tractography of the tracts: pyramidal, body of corpus callosum (CC), brainstem, uncinate fasciculus, inferior occipitofrontal fasciculus (IOF) 4-6 cingulum and fornix. We did not find significant difference in the mean FA and MD between the groups in any Results analyses. ROI analyses: total group (p=0.18), CD group (p=0.41), BSP (p=0.62), BOM (p=0.90), BOM+CD (p=0.24). Tractography analyses: pyramidal: left (FA p=0.95; MDp=0.05) and right (FA p=0.22; MD p=0.92) inferior, left (FA p=0.24; MD p=0.60) and right (FA p=0.83; MD p=0.10) middle, left (FA p=0.27, MD p=0.77) and right (FA p=0.93; MD p=0.89) superior, body of CC (FA p=0.67; MD p=0.64), brainstem (FA p=0.29; MD p=0.35), uncinate fasciculus (FA p=0.11; MD p=0.95), IOF (FA p=0.46; MDp=0.27), cingulum (FA p=0.84; MDp=0.21) and fornix (FA p=0.17; MDp=0.06).

Discussion: are no studies using DTI to evaluate the whole WM in CCD. The lack of DTI Discussion: are no studies using DTI to evaluate the whole WM in CCD. The lack of DTI changes in CCD suggests that the WM tracts are not primarily affected. WM tract involvement is 7-9 probably functional and it does not translate into morphological changes.

Conclusion: results suggest that WM tracts are not primarily affected in CCD. Further Conclusion: results suggest that WM tracts are not primarily affected in CCD. Further studies should evaluate the presence of functional and connectivity abnormalities. Study Supported by: Fapesp and CNPq.

References: et al. Movement Disorders [1] Albanese A, Bhatia K, Bressman SB, . 2013, 28: 863-73. [2] Brain Berardelli A, Rothwell JC, Hallett M, Thompson PD, Manfredi M, Marsden CD. 1998, 121:1195 - 121. Neurociências e Epilepsia [3] Rittner L, Lotufo RA. 2010, 2: 81-85. [4] Little DM, Holloway RG. Neurology et al NeuroImage 2007, 68: 9-10. [5] Smith SM, Jenkinson M, Johansen-Berg H, . 2006, 31: et al Epilepsia 1487 - 1505. [6] Campos BM, Coan AC, Beltramini GC, . 2015, Jan; 56(1):125-32 [7] et al J NeurolNeurosurg Psychiatry Colosimo C, Pantano P, Calistri V, . 2005, 76: 1591 - 1593. [8] Fabbrini et al European Journal of Neurology G, Pantano P, Totaro P, . 2008, 15: 185 - 189. [9] Colosimo C, Suppa A, et al European Journal of Neurology Fabbrini G, . 2010, 17: 15 - 21.