Cervical motion alterations and brain functional connectivity in cervical dystonia.

Evaluating the neural correlates of sensorimotor control deficits in cervical dystonia (CD) is fundamental to plan the best treatment. This study aims to assess kinematic and resting-state functional connectivity (RS-FC) characteristics in CD patients relative to healthy controls. Seventeen CD patients and 14 age-/sex-matched healthy controls were recruited. Electromagnetic sensors were used to evaluate dystonic pattern, mean/maximal cervical movement amplitude and joint position error with eyes open and closed, and movement quality during target reaching with the head. RS-fMRI was acquired to compare the FC of brain sensorimotor regions between patients and controls. In patients, correlations between motion analysis and FC data were assessed. CD patients relative to controls showed reduced mean and maximal cervical range of motion (RoM) in rotation both towards and against dystonia pattern and reduced total RoM in rotation both with eyes open and closed. They had less severe dystonia pattern with eyes open vs eyes closed. CD patients showed an altered movement quality and sensorimotor control during target reaching and a higher joint position error. Compared to controls, CD patients showed reduced FC between supplementary motor area (SMA), occipital and cerebellar areas, which correlated with lower cervical RoM in rotation both with eyes open and closed and with worse movement quality during target reaching. FC alterations between SMA and occipital and cerebellar areas may represent the neural basis of cervical sensorimotor control deficits in CD patients. Electromagnetic sensors and RS-fMRI might be promising tools to monitor CD and assess the efficacy of rehabilitative interventions.

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Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Elisabetta Sarasso reports a relationship with Italian Ministry of Health that includes: funding grants. Daniele Emedoli reports a relationship with Khymeia Group S.R.L that includes: consulting or advisory and speaking and lecture fees. Andrea Gardoni reports a relationship with none that includes:. Lucia Zenere reports a relationship with None that includes:. Elisa Canu reports a relationship with Italian Ministry of Health that includes: funding grants. Silvia Basaia reports a relationship with Italian Ministry of Health that includes: funding grants. Alberto Doretti reports a relationship with AbbVie Inc, Eli Lilly, TEVA, Lundbeck that includes: consulting or advisory. Nicola Ticozzi reports a relationship with None that includes:. Sandro Iannaccone reports a relationship with None that includes:. Stefano Amadio reports a relationship with None that includes:. Ubaldo Del Carro reports a relationship with None that includes:. Massimo Filippi reports a relationship with Alexion, Almirall, Bayer, Biogen, BMS, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, TEVA, Italian Ministry of Health, Italian Ministry of University and Research, FISM that includes: consulting or advisory, funding grants, and speaking and lecture fees. Federica Agosta reports a relationship with Biogen Idec, Italfarmaco, Roche, Zambon, Ely Lilli, Italian Ministry of Health, Italian Ministry of University and Research, AriSLA, the European Research Council, the EU JPND, and Foundation Research on Alzheimer Disease (France) that includes: funding grants and speaking and lecture fees. M. Filippi is Editor-in-Chief of the Journal of Neurology, Associate Editor of Human Brain Mapping, Neurological Sciences, and Radiology; F. Agosta is Associate Editor of NeuroImage: Clinical If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.