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| ID | Type | Description | Link |
|---|---|---|---|
| 2017-A01843-50 | Registry Identifier | RCB |
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The investigators will study the relationship between the basal ganglia and the cerebellum in dystonia by associating cerebellar stimulations with functional magnetic resonance imaging analysis.
Although dysfunctions in both basal ganglia and cerebellum in dystonia are well documented, the functional relationships between these two important motor control networks remains unclear in the context of dystonia. Here the investigators propose to tackle this issue by associating cerebellar stimulations with functional analysis using fMRI in dystonic patients.
The working hypothesis is that the primary torsion dystonia (PTD) pathophysiology involves dysfunction of striatum that is amplified by dysregulation of the cerebello-thalamo-striatal pathway.
The project is to study dystonia forms resulting primarily from dysfunctions of the striatum (patients with mutation of the ADCY5 gene) and compare them with patients with putative dysfunction of the cerebellum (patients with mutation of the PRRT2 gene) and healthy controls. In these patients, the investigators will look for (1) how cerebello-thalamo striatal pathway can be influenced by striatal dysfunctions and (2) whether cerebellar stimulation may prevent (or worsen?) the disrupted activity in the basal ganglia and (3) whether striatum-related dystonia share the same abnormal network with another form of dystonia resulting from another dysfunction (patients with PRRT2 mutation).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sham cerebellar stimulation | Sham Comparator | Participants will receive a Sham stimulation (inefficient probe) applied over the cerebellum. |
|
| Real cerebellar stimulation | Active Comparator | Participants will receive a real continuous theta burst stimulation (cTBS) applied over the cerebellum. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transcranial magnetic stimulation of the cerebellum | Other | The intervention will consist in a continuous theta burst stimulation of the cerebellum under neuronavigation. |
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| Measure | Description | Time Frame |
|---|---|---|
| Resting state functional connectivity between the cerebellum and the striatum | Synchrony between the cerebellum and the striatum, calculated from resting state fMRI done at visit2 will be compared between the 3 groups (healthy controls, ADCY5 patients, PRTT2 patients) | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Amplitude of Low Frequency Fluctuation (ALFF) of blood oxygen level-dependent signal in the cerebellum | ALFF of Blood oxygen level-dependent signal in the cerebellum will be compared between the 3 groups (healthy controls, ADCY5 patients, PRTT2 patients | 6 weeks |
| Fractional anisotropy (FA) of the cerebello-striatal tract |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Emmanuel Flamand-Roze, MD, PhD | Pitié-Salpêtrière | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Département de Neurologie, Fédération des Maladies du Système Nerveux, GH Pitié-Salpêtrière, 47 Bd de l'Hôpital | Paris | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35058336 | Result | Ekmen A, Meneret A, Valabregue R, Beranger B, Worbe Y, Lamy JC, Mehdi S, Herve A, Adanyeguh I, Temiz G, Damier P, Gras D, Roubertie A, Piard J, Navarro V, Mutez E, Riant F, Welniarz Q, Vidailhet M, Lehericy S, Meunier S, Gallea C, Roze E. Cerebellum Dysfunction in Patients With PRRT2-Related Paroxysmal Dyskinesia. Neurology. 2022 Mar 8;98(10):e1077-e1089. doi: 10.1212/WNL.0000000000200060. Epub 2022 Jan 20. | |
| 37476308 |
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| ID | Term |
|---|---|
| D004421 | Dystonia |
| ID | Term |
|---|---|
| D020820 | Dyskinesias |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
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Participants will be blinded to the TMS procedure (SHAM or real stimulation).
FA of the disynaptic tract between the cerebellum and the striatum will be compared between the 3 groups. |
| 1 day |
| Creatine concentration in the striatum measured with diffusion weighted spectroscopy. | Creatine concentration in the striatum measured from the spectroscopy, will be compared between the 3 groups | 6 weeks |
| Amplitude of Low Frequency Fluctuation (ALFF) of blood oxygen level-dependent signal in the striatum | ALFF of Blood oxygen level-dependent signal in the striatum will be compared between the 3 groups (healthy controls, ADCY5 patients, PRTT2 patients | 6 weeks |
| Resting state functional connectivity between the cerebellum and the thalamus | Synchrony between the cerebellum and the thalamus, calculated from resting state fMRI done at visit2 will be compared between the 3 groups (healthy controls, ADCY5 patients, PRTT2 patients) | 6 weeks |
| Result |
| Ekmen A, Doulazmi M, Meneret A, Jegatheesan P, Herve A, Damier P, Gras D, Roubertie A, Piard J, Mutez E, Tarrano C, Welniarz Q, Vidailhet M, Worbe Y, Gallea C, Roze E. Non-Motor Symptoms and Quality of Life in Patients with PRRT2-Related Paroxysmal Kinesigenic Dyskinesia. Mov Disord Clin Pract. 2023 Jun 5;10(7):1082-1089. doi: 10.1002/mdc3.13795. eCollection 2023 Jul. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |