20.500.12556/DiRROS-30117 Zolpidem improves task-specific dystonia a randomized clinical trial integrating exploratory transcranial magnetic stimulation and [18F] FDG-PET imaging Background Task-specific dystonia (TSFD) is a disabling movement disorder. Effective treatment options are currently limited. Zolpidem was reported to improve primary focal and generalized dystonia in a proportion of patients. The mechanisms underlying its therapeutic effects have not yet been investigated. Methods We conducted a randomized, double-blind, placebo-controlled, crossover trial of single-dose zolpidem in 24 patients with TSFD. Patients were clinically assessed using Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Writers' Cramp Rating Scale (WCRS), and Visual Analogue Scale (VAS), before and after receiving placebo and zolpidem. Transcranial magnetic stimulation was conducted on placebo and zolpidem to compare corticospinal excitability – active and resting motor thresholds (AMT and RMT), resting and active input/output curves and intracortical excitability - cortical silent period (CSP), short-interval intracortical inhibition curve (SICI), long-interval intracortical inhibition (LICI) and intracortical facilitation (ICF). Eight patients underwent brain FDG-PET imaging on zolpidem and placebo. Results Zolpidem treatment improved TSFD. Zolpidem compared to placebo flattened rest and active input/output curves, reduced ICF and was associated with hypometabolism in the right cerebellum and hypermetabolism in the left inferior parietal lobule and left cingulum. Correlations were found between changes in dystonia severity on WCRS and changes in active input/output curve and in brain metabolism, respectively. Patients with lower RMT, and higher rest and active input/output curves exhibited better response to zolpidem compared to placebo. Conclusions Zolpidem improved TSFD by reducing corticomotor output and influencing crucial nodes in higher-order sensory and motor networks Zolpidem writer's cramp musician's dystonia TMSFDG-PET true false true Angleški jezik Ni določen Neznano 2026-06-15 14:50:59 2026-06-15 14:51:00 2026-06-16 03:54:52 0000-00-00 00:00:00 2024 0 0 str. 1-9 Vol. 124 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.8 1353-8020 10.1016/j.parkreldis.2024.107014 199949571 RAZ_Vogelnik_Zakelj_Katarina_2024.pdf RAZ_Vogelnik_Zakelj_Katarina_2024.pdf 1 CF936DCD5C15CD749A4CA465C17E7BC7 8cdb3a0799018c3244f5a698706c11c768b8015728f34f431535a38894a91f02 0875a533-68b9-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45482 Univerzitetni klinični center Ljubljana 0 0 0