Mapping Movement: Advancing Understanding through PET imaging in Cervical Dystonia

Neuroimaging Deep brain stimulation (DBS) Dystonia

prof. dr. M.A.J. de Koning-Tijssen
S.A.J.E.A. Lagerweij
M. Smit

Type of project:
Pilot project (year 2 or 3) of Stage Wetenschap / Researchproject

Nature of the research:
The student will be part of a study called DECIDE (Deep brain stimulation for Cervical Dystonia, Evaluation of biomarkers), conducted at the Expertise Center Movement Disorders Groningen. This study focuses on patients undergoing deep brain stimulation (DBS) for cervical dystonia, aiming to enhance patient selection and post-surgery programming by exploring two biomarkers. The student will join a team of PhD students and neurologists. They are encouraged to attend our group’s weekly online and offline meetings, including movement disorders video meetings, work in progress sessions, research meetings in the neurology department, and the journal club.

Fields of study:
neurosurgery neurology nuclear medicine

Background / introduction
Dystonia is a movement disorder characterized by continuous or intermittent muscle contractions, resulting in abnormal movements or postures [1]. It can appear in various forms, with cervical dystonia being the most common type, involving involuntary neck movements and affecting 8000 patients in the Netherlands. Cervical dystonia also presents non-motor symptoms like psychiatric issues, pain, sleep problems, and fatigue. Although the exact cause is unknown, dystonia is seen as a brain network disorder affecting the cortico-basal ganglia-thalamo-cortical network. Studying neurotransmitters is one way to explore the pathophysiological activity of this network. The cholinergic system, associated with cognitive deficits, might play a role, and the drug trihexyfenidyl, an anticholinergic, is currently the only medication for dystonia. The recently available [18F]fluoroethoxybenzovesamicol ([18F]FEOBV) tracer for positron emission tomography (PET) allows us to study presynaptic cholinergic functioning in vivo for the first time [2]. This study aims to compare results between cervical dystonia patients and controls to understand pathophysiological mechanisms and their connection to motor and non-motor symptoms.
Research question / problem definition
- How does the vesicular acetylcholine transporter (VAChT) binding, a marker of presynaptic cholinergic functioning, differ in cervical dystonia patients compared to controls?
- How do these variations in cervical dystonia patients relate to motor and non-motor symptoms?
Initially, the student will become familiar with the study protocol and the patient population. Patients and controls will undergo various assessments, including movement registration with electromyography (EMG), an MRI- and PET-scan, and a neuropsychological investigation. Subsequently, the student will assist in preprocessing and analyzing PET-imaging data using PMOD. This will be done under the guidance of the PhD-student and experts in PET-imaging, providing an opportunity for the student to learn and ask questions. Together with the PhD-student, the student will create a statistical plan and conduct analyses with the goal of presenting the results in a scientific paper. Currently, 10 out of 15 patients and 8 out of 15 controls are included, and the pre-DBS measurements are expected to conclude by April 2024, ensuring sufficient data for meaningful conclusions by the project's end.
1. Albanese A, Bhatia K, Bressman SB, et al (2013) Phenomenology and classification of dystonia: A consensus update. Mov. Disord.
2. Aghourian M, Aumont É, Grothe MJ, et al (2021) FEOBV-PET to quantify cortical cholinergic denervation in AD: Relationship to basal forebrain volumetry. J Neuroimaging 1–5.
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