Facial synkinesis is one of the most severe sequelae of facial nerve paralysis,and it can result in facial movement disorders,abnormal facial expressions,and even problems of social communication.The underlying mechan...Facial synkinesis is one of the most severe sequelae of facial nerve paralysis,and it can result in facial movement disorders,abnormal facial expressions,and even problems of social communication.The underlying mechanism of postparalysis facial synkinesis remains unclear.In recent years,researchers have demonstrated several possible mechanisms of facial synkinesis,including aberrant regeneration,ephaptic transmission,overacting of the facial nucleus in the pons,and changes in the cerebral cortex.Management includes botulinum toxin type A(BTX-A)injection,surgery,and neuromuscular reeducation.展开更多
Facial synkinesis is a troublesome sequelae of facial nerve malfunction.It is difficult to recover from synkinesis,despite improved surgical techniques for isolating the peripheral facial nerve branches.Furthermore,it...Facial synkinesis is a troublesome sequelae of facial nerve malfunction.It is difficult to recover from synkinesis,despite improved surgical techniques for isolating the peripheral facial nerve branches.Furthermore,it remains unclear whether long-term dysfunction of motor control can lead to irreversible plasticity-induced structural brain changes.This case-control study thus investigated the structural brain alterations associated with facial synkinesis.The study was conducted at Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,China.Twenty patients with facial synkinesis(2 male and 18 female,aged 33.35±6.97 years)and 19 healthy volunteers(2 male and 17 female,aged 33.21±6.75 years)underwent magnetic resonance imaging,and voxel-based and surface-based morphometry techniques were used to analyze data.There was no significant difference in brain volume between patients with facial synkinesis and healthy volunteers.Patients with facial synkinesis exhibited a significantly reduced cortical thickness in the contralateral superior and inferior temporal gyri and a reduced sulcal depth of the ipsilateral precuneus compared with healthy volunteers.In addition,sulcal depth of the ipsilateral precuneus was negatively correlated with the severity of depression.These findings suggest that there is a structural remodeling of gray matter in patients with facial synkinesis after facial nerve malfunction.This study was approved by the Ethics Review Committee of the Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,China(approval No.2017-365-T267)on September 13,2017,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR1800014630)on January 25,2018.展开更多
文摘Facial synkinesis is one of the most severe sequelae of facial nerve paralysis,and it can result in facial movement disorders,abnormal facial expressions,and even problems of social communication.The underlying mechanism of postparalysis facial synkinesis remains unclear.In recent years,researchers have demonstrated several possible mechanisms of facial synkinesis,including aberrant regeneration,ephaptic transmission,overacting of the facial nucleus in the pons,and changes in the cerebral cortex.Management includes botulinum toxin type A(BTX-A)injection,surgery,and neuromuscular reeducation.
基金This study was financially supported by the National Key R&D Program of China,Nos.2018YFC2001600(to JGX),2018YFC2001604(to CLS)Shanghai Jiao Tong University Multidisciplinary Research Fund of Medicine and Engineering,China,No.YG 2016QN13(to WD)+2 种基金Intelligent Medical Program of Shanghai Health Commission,China,No.2018ZHYL0216(to CLS)Clinical Science and Technology Innovation Project of Shanghai Shen Kang Hospital Development Center,China,No.SHDC12018126(to JGX and CLS)Shanghai Health Commission Accelerated the Development of Traditional Chinese Medicine Three-Year Action Plan Project,China,No.ZY(2018-2020)-CCCX-2001-06(to CLS).
文摘Facial synkinesis is a troublesome sequelae of facial nerve malfunction.It is difficult to recover from synkinesis,despite improved surgical techniques for isolating the peripheral facial nerve branches.Furthermore,it remains unclear whether long-term dysfunction of motor control can lead to irreversible plasticity-induced structural brain changes.This case-control study thus investigated the structural brain alterations associated with facial synkinesis.The study was conducted at Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,China.Twenty patients with facial synkinesis(2 male and 18 female,aged 33.35±6.97 years)and 19 healthy volunteers(2 male and 17 female,aged 33.21±6.75 years)underwent magnetic resonance imaging,and voxel-based and surface-based morphometry techniques were used to analyze data.There was no significant difference in brain volume between patients with facial synkinesis and healthy volunteers.Patients with facial synkinesis exhibited a significantly reduced cortical thickness in the contralateral superior and inferior temporal gyri and a reduced sulcal depth of the ipsilateral precuneus compared with healthy volunteers.In addition,sulcal depth of the ipsilateral precuneus was negatively correlated with the severity of depression.These findings suggest that there is a structural remodeling of gray matter in patients with facial synkinesis after facial nerve malfunction.This study was approved by the Ethics Review Committee of the Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,China(approval No.2017-365-T267)on September 13,2017,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR1800014630)on January 25,2018.
