Structural brain heterogeneity underlying symptomatic and asymptomatic genetic dystonia: a multimodal MRI study

J Neurol. 2024 Apr;271(4):1767-1775. doi: 10.1007/s00415-023-12098-y. Epub 2023 Nov 29.

Abstract

Background: Most of DYT genotypes follow an autosomal dominant inheritance pattern with reduced penetrance; the mechanisms underlying the disease development remain unclear. The objective of the study was to investigate cortical thickness, grey matter (GM) volumes and white matter (WM) alterations in asymptomatic (DYT-A) and symptomatic dystonia (DYT-S) mutation carriers.

Methods: Eight DYT-A (four DYT-TOR1A and four DYT-THAP1), 14 DYT-S (seven DYT-TOR1A, and seven DYT-THAP1), and 37 matched healthy controls underwent 3D T1-weighted and diffusion tensor (DT) MRI to study cortical thickness, cerebellar and basal ganglia GM volumes and WM microstructural changes.

Results: DYT-S showed thinning of the frontal and motor cortical regions related to sensorimotor and cognitive processing, together with putaminal atrophy and subcortical microstructural WM damage of both motor and extra-motor tracts such as cerebral peduncle, corona radiata, internal and external capsule, temporal and orbitofrontal WM, and corpus callosum. DYT-A had cortical thickening of middle frontal areas and WM damage of the corona radiata.

Conclusions: DYT genes phenotypic expression is associated with alterations of both motor and extra-motor WM and GM regions. Asymptomatic genetic status is characterized by a very subtle affection of the WM motor pathway, together with an increased cortical thickness of higher-order frontal regions that might interfere with phenotypic presentation and disease manifestation.

Keywords: Cortical thickness; Genetic dystonia; Grey matter volume; MRI; White matter.

MeSH terms

  • Apoptosis Regulatory Proteins
  • Brain
  • DNA-Binding Proteins
  • Diffusion Tensor Imaging
  • Dystonia*
  • Dystonic Disorders*
  • Gray Matter
  • Humans
  • Magnetic Resonance Imaging
  • Molecular Chaperones
  • White Matter*

Substances

  • TOR1A protein, human
  • Molecular Chaperones
  • THAP1 protein, human
  • DNA-Binding Proteins
  • Apoptosis Regulatory Proteins