Oromandibular Dystonia Whole Brain Gray Matter Morphological Study, Risk Factors And Quality Of Life Survey

ObjectiveCompare the difference of gray matter of the whole brain between patients with oromandibular dystonia (OMD) and healthy controls to investigate the pathophysiological mechanism of OMD. Explore the risk factors and assess health related quality of life in patients with OMD.Method19patients with OMD were compared with19healthy volunteers matched for sex and age. High-resolution T1-weighted magnetic resonance imaging of each participant was obtained and analyzed by voxel-based morphometry (VBM).80patients with OMD and100age and gender proportion matched healthy controls were recruited. All the patients and controls were investigated by questionnaires about general conditions, social behavioral factors, environment factors, genetic factors, previous diseases,36-item short form health survey (SF-36), Hamilton anxiety and Hamilton depression scale. All of the parameters were input into a database and analyzed using statistical software IBM SPSS20.0.ResultIn patients with OMD, VBM analysis disclosed significantly larger gray matter volume (GMV) in the right cerebellar hemisphere and right postcentral gyrus and in the precuneus bilaterally in patients than in control, while gray matter volume was decreased in the right putamen, right middle temporal gyrus and left middle frontal gyrus and in the precentral gyrus bilaterally (P<0.05, unc).Multivariate analysis indicated that anxiety and depression were positively related with OMD (P<0.05). OMD demonstrated lower scores on all subscales of the SF-36compared to controls (P<0.001). OMD with cervical dystonia scored significantly lower for body pain (P<0.05). OMD with anxiety and depression had lower SF-36scores on all subscales (P<0.05).ConclusionThere are gray matter volume changes in putamen, cerebellum and sensorimotor cortex between patients with OMD and healthy controls. The pathophysiological mechanism may associate with dysfunction of sensorimotor integration, involving not only cortico-basal ganglia-thalamo-cortical loop, but the cortico-cerebello-thalamo-cortical loop as well.The risk factors of OMD are anxiety and depression. The patients with OMD have lower health related quality of life (HRQOL), and pain is more prevalent in patients with cervical dystonia. Anxiety and depression are the most important predictors of poorer HRQOL.