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The objective of this study was to investigate the basal ganglia circuit and the cerebellum during a complex motor sequence learning task carried out with the nonaffected hand in writer's cramp patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We applied structural and functional imaging in 22 writer's cramp patients and 28 matched controls using 3T <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>. With the asymptomatic left hand all participants learned a complex, sequential, five\u2010element sequence\u2010tapping task as accurately and quickly as possible. Functional imaging was measured during a repeated (15 times), fixed block design with tapping (30\u00a0sec) and rest (30\u00a0sec). Additionally, gray matter volume of the basal ganglia was analyzed using voxel\u2010based morphometry (<jats:styled-content style=\"fixed-case\">VBM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While behavior was comparable between groups, after small volume correction the anterior part of the right putamen and the left globus pallidus exhibited reduced blood oxygen level\u2010dependent (<jats:styled-content style=\"fixed-case\">BOLD<\/jats:styled-content>) activity in patients during the sequential finger\u2010tapping task. <jats:styled-content style=\"fixed-case\">VBM<\/jats:styled-content> analysis showed larger gray matter volume bilateral in the posterior part of the putamen and globus pallidus. There were no group differences in the cerebellum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results indicate an impairment of anterior basal ganglia loops involved in producing complex sequential movements of the unaffected hand. These findings are in line with previous reports of reduced neuronal activity in the globus pallidus internus. Higher gray matter volume of the putamen and globus pallidus may stem from elevated activity of the direct pathway, which could reflect a compensatory phenomenon or a primary predisposition, that is, endophenotypic trait.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.301","type":"journal-article","created":{"date-parts":[[2014,12,24]],"date-time":"2014-12-24T05:24:39Z","timestamp":1419398679000},"source":"Crossref","is-referenced-by-count":35,"title":["Increased volume and impaired function: the role of the basal ganglia in writer's cramp"],"prefix":"10.1002","volume":"5","author":[{"given":"Kirsten E.","family":"Zeuner","sequence":"first","affiliation":[{"name":"Department of Neurology Kiel University Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Knutzen","sequence":"additional","affiliation":[{"name":"Department of Neurology Kiel University Kiel 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