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University Hospitals Case Medical Center Researchers Search for Mysteries of Dystonia With Advanced Brain Imaging
Date:11/14/2011

pretty quick benefit," Dr. Walter explains. "That's not the case with dystonia – it slowly improves over a long period of time, six months or longer. So there's more of a neuroplastic effect that's probably involved in the mechanism of DBS."

The initial stage of Dr. Walter's research involves using fMRI to observe brain activity in healthy subjects and in patients with dystonia who have not received DBS implants.

"We're looking to examine how sensory and motor information is handled in the brain in patients with dystonia. Dystonia is obviously a movement disorder, but there's a lot of evidence that the integration of sensorimotor information is dysfunctional."

The research team chose to study their subjects' proprioception – the sense of how their own limbs are oriented in space – "because that's very close to movement, and you get direct feedback about joint position when you move a limb."

Using a small device that vibrates over a wrist tendon, the researchers induce a movement illusion (the false perception that the subject's wrist is flexing) and examine the resulting fMRI images.

"In our normal patients, we're seeing that the motor cortex and the motor portion of the basal ganglia and the posterior striatum are involved," Dr. Walter notes. "In our dystonic patients, we'll look for changes in how the proprioceptive input is being handled. We're hoping to discover where the signal is becoming abnormal in these patients, whether there are different anatomical structures involved, and whether there's a different place we could put the DBS wire and get a more robust effect."

The next stage of the research will include fMRI imaging of patients who have received DBS treatment. "DBS is not really well understood," Dr. Walter says "In part you need to know where to look, and this type of neuroimaging can tell us where there are abnormal hot nodes that are involved in our proprioception paradigm and may be wo
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