背景:音乐家肌张力障碍(MD)是一种运动障碍,有几个既定的危险因素,但确切的病理生理学仍然未知。最近的研究表明感觉运动功能障碍,基底神经节,小脑,和边缘循环是潜在的原因。不良的童年经历也被认为是危险因素。
目的:本研究旨在调查MD患者是否经历了更多的童年创伤,导致应激反应性增加和神经对运动障碍的脆弱性。
方法:使用功能磁共振成像和蒙特利尔成像应激任务,将40例MD患者与39例健康音乐家(HM)进行了比较。进行全脑分析和感兴趣区域分析。组间比较参数估计和主观压力水平,并与儿童创伤问卷相关。
结果:MD患者的儿童创伤评分明显高于健康对照组,但是他们的主观压力体验没有差异。在整个样本中或两组之间均未发现边缘区域的应激相关活性。相反,观察到视觉联想和颞区的活动增加,但这种激活在患者和HMs之间没有差异。然而,患者在压力下表现出减少前肌活动的趋势。不良的童年经历与precuneus呈负相关,丘脑,和所有参与者的黑质活动。
结论:总体而言,MD患者和HM对压力的主观和神经系统反应相似,但在儿童创伤经历和压力下前肌活动方面有所不同。关于前叶之间的功能连通性的进一步研究,小脑,丘脑,音乐家需要基底神经节。©2024作者(S)。由WileyPeriodicalsLLC代表国际帕金森症和运动障碍协会出版的运动障碍。
BACKGROUND: Musicians\' dystonia (MD) is a movement disorder with several established risk factors, but the exact pathophysiology remains unknown. Recent research suggests dysfunction in sensory-motor, basal ganglia, cerebellar, and limbic loops as potential causes. Adverse childhood experiences are also considered risk factors.
OBJECTIVE: This study aimed to investigate whether MD patients have experienced more childhood trauma, leading to increased stress reactivity and neural vulnerability to movement disorders.
METHODS: Using functional magnetic resonance imaging and the Montreal Imaging Stress Task, 40 MD patients were compared with 39 healthy musicians (HMs). Whole-brain analysis and regions of interest analysis were performed. Parameter estimates and subjective stress levels were compared between groups and correlated with the Childhood Trauma Questionnaire.
RESULTS: MD patients reported significantly higher childhood trauma scores than healthy control subjects, but they did not differ in their subjective stress experiences. Stress-related activity of limbic areas was neither found in the whole sample nor between the two groups. Instead, increased activity of visual association and temporal areas was observed, but this activation did not differ between patients and HMs. However, patients showed a tendency toward reduced precuneus activity under stress. Adverse childhood experiences were negatively correlated with precuneus, thalamus, and substantia nigra activity across all participants.
CONCLUSIONS: Overall, MD patients and HMs had similar subjective and neurological reactions to stress but differed in childhood trauma experiences and precuneus activity under stress. Further research about the functional connectivity between precuneus, cerebellum, thalamus, and basal ganglia in musicians is needed. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.