{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:32:50Z","timestamp":1792809170017,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T00:00:00Z","timestamp":1520294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The etiology of cervical dystonia is unknown. Cholinergic abnormalities have been identified in dystonia animal models and human imaging studies. Some animal models have cholinergic neuronal loss in the striatum and increased acetylcholinesterase activity in the pedunculopontine nucleus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objective of this study was to determine the presence of cholinergic abnormalities in the putamen and pedunculopontine nucleus in cervical dystonia human brain donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Formalin\u2010fixed brain tissues were obtained from 8 cervical dystonia and 7 age\u2010matched control brains (controls). Pedunculopontine nucleus was available in only 6 cervical dystonia and 5 controls. Neurodegeneration was evaluated pathologically in the putamen, pedunculopontine nucleus, and other regions. Cholinergic neurons were detected using choline acetyltransferase immunohistochemistry in the putamen and pedunculopontine nucleus. Putaminal cholinergic neurons were quantified. A total of 6 cervical dystonia patients and 6 age\u2010matched healthy controls underwent diffusion tensor imaging to determine if there were white matter microstructural abnormalities around the pedunculopontine nucleus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Decreased or absent choline acetyltransferase staining was identified in all 6 pedunculopontine nucleus samples in cervical dystonia. In contrast, strong choline acetyltransferase staining was present in 4 of 5 pedunculopontine nucleus controls. There were no differences in pedunculopontine nucleus diffusion tensor imaging between cervical dystonia and healthy controls. There was no difference in numbers of putaminal cholinergic neurons between cervical dystonia and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that pedunculopontine nucleus choline acetyltransferase deficiency represents a functional cholinergic deficit in cervical dystonia. Structural lesions and confounding neurodegenerative processes were excluded by absence of neuronal loss, gliosis, diffusion tensor imaging abnormalities, and beta\u2010amyloid, tau, and alpha\u2010synuclein pathologies. \u00a9 2018 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.27358","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T06:37:04Z","timestamp":1520318224000},"page":"827-834","source":"Crossref","is-referenced-by-count":21,"title":["Pedunculopontine Nucleus Cholinergic Deficiency in Cervical Dystonia"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8980-9732","authenticated-orcid":false,"given":"Karin","family":"Mente","sequence":"first","affiliation":[{"name":"Human Motor Control Section, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA"},{"name":"Louis Stokes Cleveland Veterans Affairs Medical Center Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Neuropathology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demelio","family":"Urbano","sequence":"additional","affiliation":[{"name":"Human Motor Control Section, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA"},{"name":"David Geffen School of Medicine University of California Los Angeles Los Angeles California USA"},{"name":"Charles R. 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Jackson Foundation for the Advancement of Military Research Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Tereza Di Lorenzo","family":"Alho","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Instituto do C\u00e9rebro S\u00e3o Paulo Brazil"},{"name":"Department of Radiology, Faculdade de Medicina da Universidade de S\u00e3o Paulo Instituto de Radiologia S\u00e3o Paulo Brazil"},{"name":"Department of Pathology Faculdade de Medicina da Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Joaquim Lopes","family":"Alho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculdade de Medicina da Universidade de S\u00e3o Paulo Divis\u00e3o de Neurocirurgia Funcional do Instituto de Psiquiatria\u2010Hospital das Clinicas de Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP) S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.,","given":"Edson","family":"Amaro","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein Instituto do C\u00e9rebro S\u00e3o Paulo Brazil"},{"name":"Department of Radiology, Faculdade de Medicina da Universidade de S\u00e3o Paulo Instituto de Radiologia S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvina G.","family":"Horovitz","sequence":"additional","affiliation":[{"name":"Human Motor Control Section, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hallett","sequence":"additional","affiliation":[{"name":"Human Motor Control Section, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870030302"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.08352"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neures.2011.09.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.53.1857"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10527"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5071-13.2014"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4522(96)00094-2"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001174"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-304418"},{"issue":"1","key":"e_1_2_8_11_1","first-page":"445","article-title":"The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS): assessment of validity and inter\u2010rater reliability","volume":"40","author":"Consky ES","year":"1990","journal-title":"Neurology"},{"key":"e_1_2_8_12_1","volume-title":"Cytoarchitecture of the Human Brainstem","author":"Olszewski J","year":"2014"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.10.007"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.12.1791"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00308809"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.41.4.479"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-016-0362-z"},{"key":"e_1_2_8_18_1","unstructured":"PierpaoliC WalkerL IrfanogluMO et al.TORTOISE: an integrated software package for processing of diffusion MRI data. 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