• Camila C Piccinin, Maria C A Santos, Luiza G Piovesana, Lidiane S Campos, Rachel P Guimarães, Brunno M Campos, Fabio R Torres, Marcondes C França, Augusto C Amato-Filho, Iscia Lopes-Cendes, Fernando Cendes, and Anelyssa D'Abreu.
• Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil. Electronic address: milacallegari@gmail.com.
• Parkinsonism Relat. Disord. 2014 Feb 1; 20 (2): 198-203.

BackgroundPrimary craniocervical dystonia (CCD) is generally attributed to functional abnormalities in the cortico-striato-pallido-thalamocortical loops, but cerebellar pathways have also been implicated in neuroimaging studies. Hence, our purpose was to perform a volumetric evaluation of the infratentorial structures in CCD.MethodsWe compared 35 DYT1/DYT6 negative patients with CCD and 35 healthy controls. Cerebellar volume was evaluated using manual volumetry (DISPLAY software) and infratentorial volume by voxel based morphometry of gray matter (GM) segments derived from T1 weighted 3 T MRI using the SUIT tool (SPM8/Dartel). We used t-tests to compare infratentorial volumes between groups.ResultsCerebellar volume was (1.14 ± 0.17) × 10(2) cm(3) for controls and (1.13 ± 0.14) × 10(2) cm(3) for patients; p = 0.74. VBM demonstrated GM increase in the left I-IV cerebellar lobules and GM decrease in the left lobules VI and Crus I and in the right lobules VI, Crus I and VIIIb. In a secondary analysis, VBM demonstrated GM increase also in the brainstem, mostly in the pons.ConclusionWhile gray matter increase is observed in the anterior lobe of the cerebellum and in the brainstem, the atrophy is concentrated in the posterior lobe of the cerebellum, demonstrating a differential pattern of infratentorial involvement in CCD. This study shows subtle structural abnormalities of the cerebellum and brainstem in primary CCD.Copyright © 2013 Elsevier Ltd. All rights reserved.

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