• Archives of neurology · Apr 2009

    Diffusion abnormalities in the primary sensorimotor pathways in writer's cramp.

    • Christine Delmaire, Marie Vidailhet, Demian Wassermann, Maxime Descoteaux, Romain Valabregue, Frédéric Bourdain, Christophe Lenglet, Sophie Sangla, Axel Terrier, Rachid Deriche, and Stéphane Lehéricy.
    • Department of Neuroradiology, Centre Hospitalier Régional Universitaire Roger Salengro, Lille, France.
    • Arch. Neurol. 2009 Apr 1;66(4):502-8.

    ObjectiveTo determine whether there are diffusion abnormalities along the fibers connecting sensorimotor regions, including the primary sensorimotor areas and the striatum, in patients with writer's cramp using voxel-based diffusion analysis and fiber tracking. Recent studies have shown structural changes in these regions in writer's cramp.DesignPatient and control group comparison.SettingReferral center for movement disorders.ParticipantsTwenty-six right-handed patients with writer's cramp and 26 right-handed healthy control subjects matched for sex and age.InterventionsClinical motor evaluations.Main Outcome MeasuresFractional anisotropy changes and results of fiber tracking in writer's cramp.ResultsDiffusion-tensor imaging revealed increased fractional anisotropy bilaterally in the white matter of the posterior limb of the internal capsule and adjacent structures in the patients with writer's cramp. Fiber tracking demonstrated that fractional anisotropy changes involve fiber tracts connecting the primary sensorimotor areas with subcortical structures.ConclusionsDiffusion abnormalities are present in fiber tracts connecting the primary sensorimotor areas with subcortical structures in writer's cramp. These abnormalities strengthen the role of the corticosubcortical pathways in the pathophysiologic mechanisms of writer's cramp.

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