Spontaneous Brain Activity Study In Paroxysmal Kinesigenic Dyskinesia

Paroxysmal kinesigenic dyskinesia is an involuntary movement attacks triggered by sudden voluntary movements, which has very complex clinical manifestations so that the pathology of the disorder is still unclear. Although previous researchers also investigated the two subtypes of the disease (PKD with chorea and PKD with dystonia), they failed to define the neuroimaging difference that can distinguish between them. In the study, we applied the two kinds of resting-state fMRI methods including functional segregation and functional integration to detect the difference, making the contribution to the clinical diagnosis. The detailed content as follows:Study 1. In the present study, we applied the regional homogeneity (ReHo) to study the neuroimaging difference of the two subtypes. We conducted resting-state fMRI on PKD patients with dystonia (n= 22), PKD patients with chorea (n= 10) and healthy controls (n= 32). Each group measured the local synchronization via regional homogeneity, and we also utilized the receiver operator characteristic analysis to evaluate the diagnosis potential of the two subtypes. From the results, we can find that PKD-D and PKD-C had significant ReHo in cortical-basal ganglia circuitry at the specific frequency. Morever, they existed abnormal brain spontaneous activity in the right putamen, right precuneus and right angular gyrus at a specific frequency. In addition, the imaging index ReHo distinguished between PKD-D and PKD-C effectively at the slow-5. The frequency-specific abnormal local synchronization between the 2 types of PKD offers new insights into the pathophysiology of this order to some extent.Study 2. In the part, we combined the amplitude of low frequency (ALFF) and functional connectivity (FC) to reveal the difference of the neural characteristics between PKD-D and PKD-C. We conducted resting-state fMRI on PKD patients with dystonia (n= 22), PKD patients with chorea (n= 10) and healthy controls (n= 32).From theresults of the ALFF, PKD-D and PKD-C had significant difference in left supplementary motor area, the left precuneus, left caudate nucleus and the right cerebellum. Next, we selected the left caudate as the seed to perform functional connectivity. From the results, there were significant difference in left middle occipital gyrus, left angular gyrus and left superior temporal gyrus amongst the three groups, and the two kinds of PKD had obvious distinction in the left middle occipital gyrus. All in all, aforementioned results commonly demonstrated that the two phenotypes had difference in neuromarkers. Besides, we can conclude that the functional connectivity of abnormal ALFF brain region exhibited evident difference.