The cholinergic system is involved in cervical dystonia – An [18F]FEOBV PET study

BACKGROUND: Cervical dystonia (CD) is a movement disorder characterized by involuntary muscle contractions that result in abnormal head postures and movements. In addition to motor symptoms, CD patients frequently experience non-motor symptoms such as cognitive impairment, anxiety, depression, and reduced quality of life (QoL). The cholinergic system is believed to contribute to dystonia pathophysiology, as supported by the clinical effectiveness of anticholinergic treatments. However, in vivo evidence of cholinergic dysfunction in CD is limited. OBJECTIVES: F]FEOBV PET imaging and to explore associations between cholinergic binding and motor and non-motor symptoms. METHODS: F]FEOBV binding were analyzed using volume of interest (VOI) and voxel-based approaches. Correlation analyses explored relationships between regional binding and clinical measures. RESULTS: F]FEOBV binding in the right cerebellar lobes III and IV-V in CD patients. No correlations were found between binding and motor severity, but modest associations emerged with non-motor symptoms. CONCLUSIONS: These results suggest altered cerebellar cholinergic function in CD, potentially contributing to non-motor symptomatology. Further studies are needed to clarify cholinergic mechanisms in CD.