Shared and Specific Patterns of Brain Functional Network Abnormalities in Patients With Idiopathic Dystonia and Across Subtypes

AIMS: Accumulating neuroimaging evidence showed that idiopathic dystonia is a large-scale network disorder, but whether the various clinical sub-types shared imaging abnormalities remains controversial. We aimed to determine whether various forms of idiopathic dystonia have common topological changes or are distinct entities. METHODS: Resting-state functional magnetic resonance imaging and clinical data were obtained from 215 patients with various forms of dystonia and 160 healthy controls (HCs). Whole-brain functional networks were constructed, and the topological parameters were calculated via graph theoretical analyses. Networks were compared between patients with idiopathic dystonia and HCs and in subgroup analyses (each dystonia subtype vs. HCs; one-to-one and one-to-many comparisons among blepharospasm [BSP], blepharospasm-oromandibular dystonia [BOD], and cervical dystonia [CD] subgroups). Then, we analyzed the relationship between network topological changes and clinical characteristics in patients with idiopathic dystonia. RESULTS: Compared to HCs, patients with idiopathic dystonia exhibited alterations in network integration and segregation. Subgroup analyses revealed similar changes in BSP and BOD but not in CD. Regionally, degree centrality and nodal efficiency (Ne) in the somatomotor network of patients with idiopathic dystonia decreased and increased in the subcortical and cerebellar networks. Decreased nodal clustering coefficient (Ncp) and nodal local efficiency were observed in the visual and subcortical networks. Similar regional alterations were observed in patients with BSP. Patients with idiopathic dystonia showed additional hub regions. Correlation analyses showed that higher Ne in visual and cerebellar networks correlated positively, and lower Ncp correlated negatively in the visual network with motor severity in patients with BSP. CONCLUSION: Our findings suggest that patients with BSP and BOD share extensive reorganization in the large-scale functional network.