Abstract
The underlying etiology of parkinsonian anterocollis has been the subject of recent debate. The purpose of this study is to test the hypothesis that anterocollis in parkinsonian syndromes is associated with dystonia of the deep cervical flexors (longus colli and capitis). Eight patients with anterocollis, six in the setting of parkinsonism and two primary cervical dystonia control subjects with anterocollis underwent prospective structured clinical evaluations (interview, examination and rating scales), systematic electromyography of the cervical extensor musculature and 18F-FDG PET/CT studies of cervical muscles to examine evidence of hypermetabolism or overactivity of deep cervical flexors. Subjects with parkinsonian anterocollis were found to have hypermetabolism of the extensor and sub-occipital muscles but not in the cervical flexors (superficial or deep). EMG abnormalities were observed in all evaluated patients, but only one patient was definitely myopathic. Meanwhile, both dystonia controls exhibited hypermetabolism of cervical flexors (including the longus colli). In conclusion, we were able to demonstrate hypermetabolism of superficial and deep cervical flexors with muscle 18F-FDG PET/CT in dystonic anterocollis patients, but not in parkinsonian anterocollis patients. The hypermetabolic changes seen in parkinsonian anterocollis patients in posterior muscles may be compensatory. Alternative explanations for anterocollis include myopathy of the cervical extensors, or unbalanced rigidity of the cervical flexors, but this remains to be proven.
| Original language | English |
|---|---|
| Pages (from-to) | 174-177 |
| Number of pages | 4 |
| Journal | Journal of the Neurological Sciences |
| Volume | 340 |
| Issue number | 1-2 |
| DOIs | |
| State | Published - May 15 2014 |
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Keywords
- Anterocollis
- Dystonia
- EMG
- FDG-PET
- Parkinson's disease
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
An 18F-FDG PET study of cervical muscle in parkinsonian anterocollis. / Revuelta, Gonzalo J.; Montilla, Jaime; Benatar, Michael G; Freeman, Alan; Wichmann, Thomas; Jinnah, Hyder A.; Delong, Mahlon R.; Factor, Stewart A.
In: Journal of the Neurological Sciences, Vol. 340, No. 1-2, 15.05.2014, p. 174-177.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An 18F-FDG PET study of cervical muscle in parkinsonian anterocollis
AU - Revuelta, Gonzalo J.
AU - Montilla, Jaime
AU - Benatar, Michael G
AU - Freeman, Alan
AU - Wichmann, Thomas
AU - Jinnah, Hyder A.
AU - Delong, Mahlon R.
AU - Factor, Stewart A.
PY - 2014/5/15
Y1 - 2014/5/15
N2 - The underlying etiology of parkinsonian anterocollis has been the subject of recent debate. The purpose of this study is to test the hypothesis that anterocollis in parkinsonian syndromes is associated with dystonia of the deep cervical flexors (longus colli and capitis). Eight patients with anterocollis, six in the setting of parkinsonism and two primary cervical dystonia control subjects with anterocollis underwent prospective structured clinical evaluations (interview, examination and rating scales), systematic electromyography of the cervical extensor musculature and 18F-FDG PET/CT studies of cervical muscles to examine evidence of hypermetabolism or overactivity of deep cervical flexors. Subjects with parkinsonian anterocollis were found to have hypermetabolism of the extensor and sub-occipital muscles but not in the cervical flexors (superficial or deep). EMG abnormalities were observed in all evaluated patients, but only one patient was definitely myopathic. Meanwhile, both dystonia controls exhibited hypermetabolism of cervical flexors (including the longus colli). In conclusion, we were able to demonstrate hypermetabolism of superficial and deep cervical flexors with muscle 18F-FDG PET/CT in dystonic anterocollis patients, but not in parkinsonian anterocollis patients. The hypermetabolic changes seen in parkinsonian anterocollis patients in posterior muscles may be compensatory. Alternative explanations for anterocollis include myopathy of the cervical extensors, or unbalanced rigidity of the cervical flexors, but this remains to be proven.
AB - The underlying etiology of parkinsonian anterocollis has been the subject of recent debate. The purpose of this study is to test the hypothesis that anterocollis in parkinsonian syndromes is associated with dystonia of the deep cervical flexors (longus colli and capitis). Eight patients with anterocollis, six in the setting of parkinsonism and two primary cervical dystonia control subjects with anterocollis underwent prospective structured clinical evaluations (interview, examination and rating scales), systematic electromyography of the cervical extensor musculature and 18F-FDG PET/CT studies of cervical muscles to examine evidence of hypermetabolism or overactivity of deep cervical flexors. Subjects with parkinsonian anterocollis were found to have hypermetabolism of the extensor and sub-occipital muscles but not in the cervical flexors (superficial or deep). EMG abnormalities were observed in all evaluated patients, but only one patient was definitely myopathic. Meanwhile, both dystonia controls exhibited hypermetabolism of cervical flexors (including the longus colli). In conclusion, we were able to demonstrate hypermetabolism of superficial and deep cervical flexors with muscle 18F-FDG PET/CT in dystonic anterocollis patients, but not in parkinsonian anterocollis patients. The hypermetabolic changes seen in parkinsonian anterocollis patients in posterior muscles may be compensatory. Alternative explanations for anterocollis include myopathy of the cervical extensors, or unbalanced rigidity of the cervical flexors, but this remains to be proven.
KW - Anterocollis
KW - Dystonia
KW - EMG
KW - FDG-PET
KW - Parkinson's disease
UR - http://www.scopus.com/inward/record.url?scp=84899941438&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899941438&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2014.03.023
DO - 10.1016/j.jns.2014.03.023
M3 - Article
C2 - 24725739
AN - SCOPUS:84899941438
VL - 340
SP - 174
EP - 177
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
IS - 1-2
ER -