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NEUROLOGY 2005;65:1562-1569
© 2005 American Academy of Neurology

"Silent event-related" fMRI reveals reduced sensorimotor activation in laryngeal dystonia

B. Haslinger, MD, P. Erhard, PhD, C. Dresel, MD, F. Castrop, MD, M. Roettinger, MD and A. O. Ceballos-Baumann, MD

From the Neurologische Klinik (Drs. Haslinger, Erhard, Dresel, Castrop, and Ceballos-Baumann), Nuklearmedizinische Klinik (Dr. Erhard), and Institut für Röntgendiagnostik (Drs. Erhard and Roettinger), TU-München, Munich; and Neurologisches Krankenhaus München (Dr. Ceballos-Baumann), Munich, Germany.

Address correspondence and reprint requests to Dr. Bernhard Haslinger, Neurologische Klinik, TU-München, Möhlstrasse 28, D-81675 Munich, Germany; e-mail: b.haslinger{at}lrz.tu-muenchen.de

Objective: To study with fMRI the pattern of sensorimotor activation in patients with spasmodic dysphonia (laryngeal dystonia) compared to healthy controls.

Methods: The authors performed fMRI measurements during vocal motor tasks in 12 patients with laryngeal dystonia and compared them with those of 12 healthy volunteers. Patients were scanned before (pre) and after (post) treatment with local injections of botulinum toxin (BTX). They examined two different motor tasks: simple vocalization inducing dystonia and whispering without appearance of dystonic symptoms. To avoid movement artifacts with oral motor tasks, the authors used a silent event-related fMRI approach involving noncontinuous sampling with no data acquisition during task performance.

Results: They found reduced activation of primary sensorimotor as well as of premotor and sensory association cortices during vocalization in patients with laryngeal dystonia pre-BTX. This was partly observed also during the asymptomatic whispering task. BTX treatment did not result in reversal of reduced cortical activation.

Conclusion: fMRI signal is reduced in sensorimotor cortices associated with movement of the affected body part in laryngeal dystonia, supporting a dystonic basis for this voice disorder.

Supported by grants Ce 33/4.1 and 4.2 from the Deutsche Forschungsgemeinschaft Bonn.

Disclosure: The authors report no conflicts of interest.

Received March 8, 2005. Accepted in final form August 1, 2005.




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