This study will use high-resolution magnetic resonance imaging (MRI) to look for subtle differences in brain anatomy between patients with focal hand dystonia (also called writer's cramp) and healthy normal volunteers. Patients with hand dystonia have prolonged muscle contractions that cause sustained twisting movements and abnormal postures. These abnormal movements often occur with activities such as writing, typing, playing certain musical instruments such as guitar or piano, or playing golf or darts.

Patients with focal hand dystonia and healthy volunteers will be enrolled in this study. Patients will be recruited from NINDS's database of patients with focal hand dystonia. Volunteers will be selected to match the patients in age, sex and handedness.

This study involves two visits to the NIH Clinical Center. The first visit is a screening visit, in which patients and volunteers will have a medical history, physical examination, neurological examination, and assessment of handedness. Women of childbearing age will be screened with a pregnancy test. Pregnant women are exclude from this study.

Those who join the study will return for a second visit for magnetic resonance imaging. MRI uses a magnetic field and radio waves to produce images of the brain. For the procedure, the participant lies still on a stretcher that is moved into the scanner (a narrow cylinder containing the magnet). Earplugs are worn to muffle loud noises caused by electrical switching of radio frequency circuits used in the scanning process. The scan will last about 45 to 60 minutes, at most. Some volunteers may be asked to return for a third visit to obtain a second MRI on a different scanner.

Condition
Dystonia Healthy

The term, dystonia, is used to describe a syndrome characterized by prolonged muscle contractions causing sustained twisting movements and abnormal postures of the affected body part(s). Although no structural brain abnormalities have been definitely demonstrated in visual inspection of MRI scans from patients with primary focal hand dystonia, there are several lines of evidence for subtle structural brain abnormalities at both subcortical and cortical levels. We hypothesize that those abnormalities might be detected using appropriate acquisition and analysis methods. The aim of the present study is to use high-resolution 3D structural magnetic resonance imaging (MRI) of the brain and voxel-based morphometry (VBM) to detect structural changes in patients with primary focal dystonia in comparison with control subjects. VBM is a method implemented in the statistical parametric mapping software (SPM2) that allows a voxel-wise comparison of local concentration/volume of gray/white matter between two groups of subjects. This study can lead to an improved knowledge of the pathophysiology of primary hand dystonia can help to elucidate dystonia's pathogenesis/etiology and may lead to specific preventative or therapeutic approaches.

Genders Eligible for Study:  Both

Accepts Healthy Volunteers

Criteria

INCLUSION CRITERIA:
NORMAL SUBJECTS:
Healthy volunteers who consented to participate in the study and matched for age, sex, handedness with the group of patients with primary focal hand dystonia.
PATIENTS:
Patients with unilateral primary focal hand dystonia from our dystonia patient database who consented to participate in the study. This criterion will be established by the preliminary screening in the Human Motor Control Outpatient Clinic.
Female patients of child bearing potential will have a pregnancy test prior to the MRI to ensure that pregnant subjects will not participate in the study.
EXCLUSION CRITERIA:
Normal subjects with cognitive complaints, abnormal neurological exam or history of past neurological disease.
Dystonia patients with the presence of a second neurological disease or condition; abnormal neurological findings on exam that are not related to primary focal hand dystonia.
Subjects with past or present neuropsychiatric illness, head trauma with loss of consciousness, epilepsy, cerebro-vascular disease, migraine, past and present history of alcohol abuse, medical conditions that may alter cerebral structure.
Subjects with abnormal MRI findings at visual inspection (prominent normal variants such as mega cisterna or cavum septum pellucidum, signs of severe cortical or subcortical atrophy, brain tumors, vascular diseases, trauma or AVMs).
Subjects with any metallic objects within them just prior to MR imaging (cardiac or neural pacemaker, aneurysm clips [metal clips on the wall of a large artery], metallic prostheses [including heart valves and cochlear implants] or shrapnel fragments. Welders and metal workers are also at risk for injury and may not take part in the study because of possible small fragments in the eye of which they may be unaware.
Subjects not capable of giving an informed consent.
Children will be excluded from the study.

Maryland
      National Institute of Neurological Disorders and Stroke (NINDS), 9000 Rockville Pike,  Bethesda,  Maryland,  20892,  United States; Recruiting

Study ID Numbers:  020132; 02-N-0132
Record last reviewed:  January 29, 2004
Last Updated:  January 29, 2004
Record first received:  March 2, 2002
ClinicalTrials.gov Identifier:  NCT00031369
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2004-11-08