{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:35:29Z","timestamp":1791250529451,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,3,18]],"date-time":"2009-03-18T00:00:00Z","timestamp":1237334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>One approach to the treatment of focal hand dystonia (FHD) is via sensory\u2010based training regimes. It is known that FHD patients demonstrate a reduced distance between the representations of digits 1 and 5 and also digits 2 and 5 in primary somatosensory cortex. However, we lack information on the spatial relationships among digits, such as reduced inter\u2010digit spacing or shifts of representations within the cortical areas, and whether aberrations are specific to symptomatic digits. Our aim was to characterize the spatial relationships among individual digits to determine the types of aberrations that exist and whether these are specific to symptomatic digits only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using high\u2010resolution fMRI over a limited volume and surface\u2010based mapping techniques, the cortical representations of all digits of the dystonia\u2010affected hand within the sub\u2010regions of the postcentral gyrus were mapped in patients with task\u2010specific Writer's cramp (WC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In area 3b, digits directly involved in writing (D1, D2 and D3) show reduced inter\u2010digit separation, reversals, and overlapping activation. The thumb representation occupies territory normally occupied by digit 2 in controls. Asymptomatic digits 4 and 5 preserve their inter\u2010digit separation yet shift towards the D1\/D2\/D3 cluster, suggesting that reduced spacing, not simply digit shifts, are associated with dystonia symptoms. Area 3a was less responsive to sensory input in WC patients providing evidence of reduced afferent drive or top\u2010down modulation to this sub\u2010region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Therapeutic regimes aimed at facilitating inter\u2010digit separation of digits 1, 2 and 3 may promote beneficial plasticity in WC patients. 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