Brain dynamic neurochemical changes in dystonic patients: A magnetic resonance spectroscopy study

Authors

  • Malgorzata Marjańska PhD,

    1. Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
    Search for more papers by this author
  • Stéphane Lehéricy MD, PhD,

    1. Centre de NeuroImagerie de Recherche—CENIR, Paris, France
    2. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    3. CNRS, Paris, France
    4. Inserm, U975, Paris, France
    5. ICM—Institut du Cerveau et de la Moelle épinière, Paris, France
    6. Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    Search for more papers by this author
  • Romain Valabrègue PhD,

    1. Centre de NeuroImagerie de Recherche—CENIR, Paris, France
    Search for more papers by this author
  • Traian Popa PhD,

    1. Centre de NeuroImagerie de Recherche—CENIR, Paris, France
    2. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    3. CNRS, Paris, France
    4. Inserm, U975, Paris, France
    5. ICM—Institut du Cerveau et de la Moelle épinière, Paris, France
    Search for more papers by this author
  • Yulia Worbe MD, PhD,

    1. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    2. CNRS, Paris, France
    3. Inserm, U975, Paris, France
    4. ICM—Institut du Cerveau et de la Moelle épinière, Paris, France
    Search for more papers by this author
  • Margherita Russo MD,

    1. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    2. CNRS, Paris, France
    3. Inserm, U975, Paris, France
    Search for more papers by this author
  • Edward J. Auerbach PhD,

    1. Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
    Search for more papers by this author
  • David Grabli MD, PhD,

    1. Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    Search for more papers by this author
  • Cecilia Bonnet MD,

    1. Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    2. Department of Neurology, Charles University in Prague, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
    Search for more papers by this author
  • Cécile Gallea PhD,

    1. Centre de NeuroImagerie de Recherche—CENIR, Paris, France
    Search for more papers by this author
  • Mathieu Coudert MA,

    1. Clinical Research Unit, Pitié-Salpêtrière Hospital, Paris, France
    2. Department of Biostatistics and Medical Informatics, Pitié-Salpêtrière Hospital, Paris, France
    Search for more papers by this author
  • Lydia Yahia-Cherif,

    1. Centre de NeuroImagerie de Recherche—CENIR, Paris, France
    2. CNRS, Paris, France
    Search for more papers by this author
  • Marie Vidailhet MD,

    1. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    2. CNRS, Paris, France
    3. Inserm, U975, Paris, France
    4. ICM—Institut du Cerveau et de la Moelle épinière, Paris, France
    5. Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    Search for more papers by this author
  • Sabine Meunier MD, PhD

    Corresponding author
    1. Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
    2. CNRS, Paris, France
    3. Inserm, U975, Paris, France
    4. ICM—Institut du Cerveau et de la Moelle épinière, Paris, France
    • Correspondence to: Dr. Sabine Meunier, bâtiment ICM CIC, Room 1040, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France; sabine.meunier@upmc.fr

    Search for more papers by this author

  • Funding agencies: This work was supported by l'Agence Nationale de le Recherche (project ANR-07-NEURO-023-01), Assistance Publique–Hôpitaux de Paris (P060502), the Lilly Institute, and the Institut Fédératif de Recherche 49 (IFR 49), CEA, NeuroSpin, Gif-sur-Yvette, France. The research was also supported by the French dystonia foundations (AMADYS and Alliance France Dystonie). M Marjańska and EJ Auerbach acknowledge support by Biotechnology Research Center (BTRC) grant P41 RR008079 (NCRR) and P41 EB015894 (NIBIB) and NCC P30 NS057091.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Measurements of the concentrations of γ-aminobutyric acid (GABA) and glutamate in the motor cortices and lentiform nuclei of dystonic patients using single-voxel 1H magnetic resonance spectroscopy (MRS) have yielded conflicting results so far. This study aimed to investigate dynamic changes in metabolite concentrations after stimulation of the motor cortices in patients with upper limb dystonia. Using single-voxel MRS at 3 T, the concentrations of GABA, glutamate plus glutamine, and N-acetylaspartate were measured bilaterally in the primary sensorimotor cortex, lentiform nucleus, and occipital region before and after 5-Hz transcranial magnetic stimulation (TMS) over the dominant motor cortex. Data obtained from 15 patients with upper limb primary dystonia were compared with data obtained from 14 healthy volunteers. At baseline, there was no group difference in concentration of metabolites in any region. rTMS induced a local (in the stimulated motor cortex) decrease of N-acetylaspartate (P < .006) to the same extent in healthy volunteers and patients. GABA concentrations were modulated differently, however, decreasing mildly in patients and increasing mildly in healthy volunteers (P = .05). There were no remote effects in the lentiform nucleus in either group. The stimulation-induced changes in metabolite concentrations have been interpreted in view of the increased energy demand induced by rTMS. The dynamics of the GABA concentration were specifically impaired in dystonic patients. Whether these changes reflect changes in the extrasynaptic or synaptic GABA component is discussed. © 2012 Movement Disorder Society

Ancillary