Abstract Details

Title Modulation of Cerebral Sensorimotor Circuits during Botulinum Toxin Treatment of Cervical Dystonia

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 193

Objective

Background BACKGROUND: Neurophysiological and lately also functional brain imaging studies in cervical dystonia (CD) patients indicate a disorder of sensorimotor integration within extensive cortico-subcortical brain networks. Intramuscular botulinum toxin type A (BoNT-A) application has a proven clinical effect on pathological muscle activation in CD but recently has also been shown to modulate sensorimotor networks.

Design/Methods DESIGN/METHODS: We have studied 12 BoNT-A naive CD patients using functional MRI during hand motor task performance. Clinical and imaging examinations were performed before the first BoNT-A application and subsequently 4 weeks after application, at the time of maximal clinical effect of BoNT-A. Clinical treatment response was evaluated with the Tsui score, functional MRI data were analyzed with a general linear model implemented in FSL software, treatment effects were tested in pair-wise linear contrasts.

Results RESULTS: Comparing motor task-induced activations demonstrated bilateral increase after treatment in several bilateral frontoparietal areas, ipsilateral insula and thalamus.

Conclusions CONCLUSIONS: Within the context of previously described sensorimotor network hypoactivation during motor task performance in CD, our observed effect of activation increase after first BoNT-A application may be interpreted as approaching the physiological state. Central effect of repeated BoNT-A applications is somewhat different, which likely corresponds to the gradual evolution of the clinical responses to repeated BoNT-A treatment in cervical dystonia.

Authors/Disclosures
Petr Hlustik, MD, PhD (Palacký University Olomouc) PRESENTER	The institution of Prof. Hlustik has received research support from Czech Health Research Council (AZV CR).
Xavier Montalban, MD, PhD, FAAN (Vall Hebron University Hospital-Multiple Sclerosis Centre of Catalonia)	The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck/ EMD Serono. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Hoffmann-La Roche. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Actelion/ Janssen Pharmaceuticals. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BMS/ Celgene. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/ Genzyme. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BIAL PD. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PeerVoice. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Samsung Biosys. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas BioPharma. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Actelion/ Janssen Pharmaceuticals. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS/ Celgene. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck/ EMD Serono. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffmann-La Roche. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic Therapeutics. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viatris/ Mylan. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. The institution of Dr. Montalban has received research support from Biogen. The institution of Dr. Montalban has received research support from Hoffmann-La Roche. The institution of Dr. Montalban has received research support from Sanofi/ Genzyme. The institution of Dr. Montalban has received research support from Merck/ EMD Serono. The institution of Dr. Montalban has received research support from Novartis. The institution of Dr. Montalban has received research support from Teva Pharmaceuticals. The institution of Dr. Montalban has received research support from Actelion/ Janssen Pharmaceuticals. The institution of Dr. Montalban has received research support from BMS/ Celgene.
Martin Nevrly, MD (FN Olomouc)	No disclosure on file
	No disclosure on file
	No disclosure on file
Pavel Hok, MD (University Hospital Olomouc)	Dr. Hok has nothing to disclose.
	No disclosure on file
Petr Kanovsky, PhD	Dr. Kanovsky has nothing to disclose.

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