Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia

Kirke, Diana N., Battistella, Giovanni, Kumar, Veena, Rubien-Thomas, Estee, Choy, Melissa, Rumbach, Anna and Simonyan, Kristina (2016) Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia. Brain Imaging and Behavior, 11 1: 1-10. doi:10.1007/s11682-016-9513-x

Author Kirke, Diana N.
Battistella, Giovanni
Kumar, Veena
Rubien-Thomas, Estee
Choy, Melissa
Rumbach, Anna
Simonyan, Kristina
Title Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia
Journal name Brain Imaging and Behavior   Check publisher's open access policy
ISSN 1931-7565
Publication date 2016-02-03
Year available 2017
Sub-type Article (original research)
DOI 10.1007/s11682-016-9513-x
Open Access Status Not Open Access
Volume 11
Issue 1
Start page 1
End page 10
Total pages 10
Place of publication New York, United States
Publisher Springer
Language eng
Subject 2741 Radiology Nuclear Medicine and imaging
2808 Neurology
2805 Cognitive Neuroscience
2728 Clinical Neurology
2804 Cellular and Molecular Neuroscience
2738 Psychiatry and Mental health
2802 Behavioral Neuroscience
Abstract Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.
Keyword Dystonic tremor
Laryngeal dystonia
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID R01DC012545
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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School of Health and Rehabilitation Sciences Publications
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