Previous studies suggested that brain regions subtending affective‐cognitive processes can be implicated in the pathophysiology of functional dystonia (FD). In this study, the role of the affective‐cognitive network was explored in two phenotypes of FD: fixed (FixFD) and mobile dystonia (MobFD). We hypothesized that each of these phenotypes would show peculiar functional connectivity (FC) alterations in line with their divergent disease clinical expressions. Resting state fMRI (RS‐fMRI) was obtained in 40 FD patients (12 FixFD; 28 MobFD) and 43 controls (14 young FixFD‐age‐matched [yHC]; 29 old MobFD‐age‐matched [oHC]). FC of brain regions of interest, known to be involved in affective‐cognitive processes, and independent component analysis of RS‐fMRI data to explore brain networks were employed. Compared to HC, all FD patients showed reduced FC between the majority of affective‐cognitive seeds of interest and the fronto‐subcortical and limbic circuits; enhanced FC between the right affective‐cognitive part of the cerebellum and the bilateral associative parietal cortex; enhanced FC of the bilateral amygdala with the subcortical and posterior cortical brain regions; and altered FC between the left medial dorsal nucleus and the sensorimotor and associative brain regions (enhanced in MobFD and reduced in FixFD). Compared with yHC and MobFD patients, FixFD patients had an extensive pattern of reduced FC within the cerebellar network, and between the majority of affective‐cognitive seeds of interest and the sensorimotor and high‐order function (“cognitive”) areas with a unique involvement of dorsal anterior cingulate cortex connectivity. Brain FC within the affective‐cognitive network is altered in FD and presented specific features associated with each FD phenotype, suggesting an interaction between brain connectivity and clinical expression of the disease.

中文翻译：

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功能性肌张力障碍中情感认知网络的破坏。

先前的研究表明，对着情感认知过程的大脑区域可能与功能性肌张力障碍 (FD) 的病理生理学有关。在这项研究中，情感认知网络在 FD 的两种表型中的作用进行了探索：固定 (FixFD) 和移动性肌张力障碍 (MobFD)。我们假设这些表型中的每一个都会显示出与其不同的疾病临床表现一致的特殊功能连接 (FC) 改变。在 40 名 FD 患者（12 名 FixFD；28 名 MobFD）和 43 名对照（14 名年轻 FixFD 年龄匹配 [yHC]；29 名老年 MobFD 年龄匹配 [oHC]）中获得静息状态 fMRI (RS-fMRI)。使用已知参与情感认知过程的大脑感兴趣区域的 FC 和 RS-fMRI 数据的独立成分分析来探索大脑网络。与HC相比，所有 FD 患者在大多数感兴趣的情感认知种子与额叶皮层下和边缘回路之间都表现出减少的 FC；小脑右侧情感认知部分与双侧联合顶叶皮层之间的 FC 增强；双侧杏仁核与皮质下和后皮质脑区的 FC 增强；左内侧背核与感觉运动和联想大脑区域之间的 FC 改变（在 MobFD 中增强，在 FixFD 中减少）。与 yHC 和 MobFD 患者相比，FixFD 患者在小脑网络内以及大多数感兴趣的情感认知种子与感觉运动和高阶功能（“认知”）区域之间具有广泛的 FC 减少模式，具有独特的参与背侧前扣带回皮质连接。