Neuroimaging Advances in Brain Function of Laryngeal Dystonia: A Systematic Review
Clinical Snapshot
PICO Framework
| P — Population | Patients with laryngeal dystonia (LD) |
| I — Intervention | Neuroimaging techniques (functional MRI, voxel-based morphometry) |
| C — Comparator | Healthy controls or baseline measurements |
| O — Outcomes | Brain structural and functional abnormalities, pathophysiological mechanisms |
Bottom Line
This systematic review of 33 neuroimaging studies provides valuable insights into the pathophysiology of laryngeal dystonia, identifying consistent patterns of brain dysfunction involving the cortico-basal ganglia-thalamo-cerebellar circuit. Key findings include gray matter alterations in sensorimotor areas, reduced thalamic volume, impaired white matter integrity, and characteristic patterns of hypoactivation (M1/S1, cerebellum) and hyperactivation (pallidum, thalamus). However, the clinical utility is currently limited by significant methodological heterogeneity across studies and lack of therapeutic implications. While this work advances our understanding of laryngeal dystonia pathophysiology, it does not provide evidence to change current clinical practice. The findings may inform future research directions and potentially guide development of targeted therapies, but more standardized research methodologies and therapeutic studies are needed before clinical translation.
Key Findings
P Value: Not applicable for systematic review
Effect Size: Not quantified - qualitative synthesis only
Primary Outcome: Brain structural and functional abnormalities in laryngeal dystonia
Nnt Or Sensitivity: Not applicable - diagnostic/mechanistic review
Confidence Interval: Not reported
Clinical Application
Limited immediate clinical application as findings are primarily mechanistic rather than therapeutic Relevant to Australian neurologists and ENT specialists managing dystonia; may inform future research directions but limited immediate practice implications Patients with laryngeal dystonia presenting to otolaryngology, neurology, or speech pathology services
Abstract
PURPOSE: This study aims to review neuroimaging research on brain function in laryngeal dystonia (LD), summarize current evidence on its pathophysiological mechanisms, and highlight directions for future investigation. METHOD: PubMed, Scopus, and Web of Science Core Collection were searched from database inception to November 2025. Two reviewers independently screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Eligible studies were synthesized through systematic review and visual analysis. RESULTS: A total of 33 studies were included. These studies employed imaging techniques such as functional magnetic resonance imaging and voxel-based morphometry to identify abnormalities in patients with LD. Structurally, key findings include gray matter alterations in sensorimotor areas, reduced thalamic volume, and impaired white matter integrity. Functionally, this manifests as sensorimotor integration dysfunction (characterized by M1/S1 and cerebellar hypoactivation alongside pallidal and thalamic hyperactivation) and network decoupling (e.g., weakened M1-S1 connectivity). CONCLUSIONS: The pathological mechanism of LD is a complex network imbalance involving the core "cortico-basal ganglia-thalamo-cerebellar" loop, driven primarily by sensorimotor integration dysfunction. Current research is limited in quantity and suffers from significant methodological heterogeneity. Future studies should further clarify the functional interactions among brain regions and their relationship with clinical symptoms, thereby providing a theoretical basis for the development of targeted therapies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31329103.
References
- 1.Hu, Y., Xing, L., Wu, S., & Zhuang, P. (2026). Neuroimaging advances in brain function of laryngeal dystonia: A systematic review. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2025_JSLHR-25-00663
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