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Brain Scans Reveal Secrets of 'Writer's Cramp'

Condition may arise from abnormalities in nerve fiber bundles, scientists say

WEDNESDAY, April 15 (HealthDay News) -- A team of French researchers has linked abnormalities in certain neural pathways of the brain to the debilitating muscle disorder known as "writer's cramp."

The finding could lead to a better understanding of the neurological basis for the resulting loss of muscle control and coordination that characterizes this difficult-to-diagnose disorder -- also known as "hand dystonia." The condition can render a patient unable to write or even maintain a functional grip when trying to perform a simple task.

"These results demonstrate the presence of abnormalities in [brain] fiber tracts," that are located in areas known to be involved with writer's cramp, said study author Dr. Stephane Lehericy, director of the Center for NeuroImaging Research at Pitie-Salpetriere Hospital in Paris.

Lehericy explained that although prior research had already linked writer's cramp to problematic alterations in the gray matter in certain brain regions, the current investigation identified problems with the white matter of certain nerve pathways in brain areas that are responsible for generating motor commands.

Such white matter, explained Lehericy, "contains fiber bundles that convey information from one brain region to another, as well as to the spinal cord."

Lehericy and his team reported the findings in the April issue of the Archives of Neurology.

To explore linkages between the disorder and the brain, the French team conducted high-tech diffusion-tenor magnetic resonance imaging (DTI) to scan for brain abnormalities among 26 right-handed writer's cramp patients and 26 right-handed healthy participants.

Among the writers cramp patients, the scans uncovered structural abnormalities in the white matter from the primary sensorimotor cortex region of the brain to below-cortex regions such as the thalamus. The observed abnormalities were not present among the healthy participants.

Such connections, the researchers noted, are typically key to the proper transference of motor coordination instructions from the brain to the spine, brain guidance that ultimately enables proper limb movement.

Dr. Daniel Labovitz, director of the division of cerebral vascular disease at New York University's Langone Medical Center, said the French researchers used "a very interesting technique to look at a very interesting problem."

"This is a solid piece of work," he said, "and a fascinating area of research that touches on issues that go far beyond writer's cramp alone and has to do with a whole range of activity-related difficulties that clearly have to do with a problem with the brain."

"So this study builds on the little knowledge we have on an exceedingly rare and unusual issue for which we have virtually no treatment," Labovitz added. "No, this finding doesn't tell us what the brain changes mean exactly. But it does add incrementally and importantly to our understanding of the neurology underlying the problem."

More information

For more on writer's cramp, head to the Dystonia Medical Research Foundation.

SOURCES: Stephane Lehericy, M.D., Ph.D., director, Center for NeuroImaging Research, and professor, department of neuroradiology, Pitie-Salpetriere Hospital, Paris; Daniel Labovitz, M.D., director, division of cerebral vascular disease, New York University Langone Medical Center, and assistant professor, neurology, NYU School of Medicine, New York City; April 2009 Archives of Neurology

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