Differences in functional brain alterations driven by right or left facial nerve efferent dysfunction: Evidence from early Bell's palsy
Differences in functional brain alterations driven by right or left facial nerve efferent dysfunction: Evidence from early Bell's palsy
复制标题
左右面神经传出功能障碍驱动的大脑功能改变的差异：来自早期贝尔麻痹的证据
DOI：
10.21037/qims.2019.02.13
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发表时间：
2019-03-01
影响因子：
2.8
通讯作者：
Ma, Guolin
中科院分区：
文献类型：
--
作者：
Han, Xiaowei;Li, Haimei;Ma, Guolin
背景：贝尔麻痹是一种特发性单侧面神经麻痹。早期Bell麻痹的特征是出现面神经运动传导不对称和面部肌肉运动明显失衡，可对患者造成实质性心理影响，并触发大脑皮层功能重组。然而，在早期贝尔麻痹患者中，由右侧或左侧面神经传出功能障碍驱动的脑功能改变之间的差异尚不完全清楚。对不同侧Bell麻痹患者进行早期神经影像学研究，有助于了解单侧面传出神经功能障碍驱动功能整合的不同机制，为选择合适的治疗策略提供理论依据。方法：招募67名患者和37名年龄和性别匹配的健康对照者进行静息态功能磁共振成像（R-fMRI）。通过比较右侧瘫痪和健康对照组、左侧瘫痪和健康对照组以及右侧和左侧瘫痪组之间的低频波动分数振幅（fALFF）来分析局部脑活动。进一步选择改变的脑区作为随后的功能连接（FC）分析的种子，并分析多伦多面部评分系统（TFGS）评分与连接改变之间的相关性。与健康对照组相比，右侧和左侧Bell麻痹组显示fALFF改变，并鉴定了在右侧和左侧麻痹组之间具有不同fALFF值的几个脑区域。在右侧麻痹组中，与左侧麻痹组相比，右侧缘上回（SMG）、双侧上级额回（SFG）和左侧中央前回（PreCG）的整体区域间FC增加。右侧麻痹组FC值较高的脑区对依次为左侧颞上级回颞极（TPOsup）与右侧SMG、左侧TPOsup与扣带回中部（MCC）、左侧TPOsup与左侧PreCG、右侧SMG与SFG、MCC与左侧PreCG、左侧与右侧SFG、右侧SFG与左侧PreCG。右侧瘫痪组左侧TPOsup、PreCG与TFGS评分呈负相关，右侧SFG、PreCG与TFGS评分呈正相关。在左侧麻痹组中，左侧TPOsup和右侧SMG，以及右侧SMG和SFG区域对与TFGS score.Conclusions呈负相关：fALFF和FC分析揭示了不同的脑功能网络的重塑驱动的右侧或左侧面神经传出功能障碍的早期贝尔麻痹患者。右侧和左侧贝尔麻痹患者的重返社会机制不同。此外，疾病的严重程度与FC改变有不同的相关性。
Background: Bell's palsy is defined as idiopathic unilateral facial nerve palsy. Early Bell's palsy is characterized by emerging asymmetric motor conduction of the facial nerve and obvious imbalance of facial muscle movement, which can result in a substantial psychological impact on patients and trigger brain cortical functional reorganization. However, the differences between the brain functional alterations were driven by right or left facial nerve efferent dysfunction in patients with early Bell's palsy are not fully understood. The neuroimage study in patients with different-sided Bell's palsy in the early stage will help to understand the different mechanisms involved in functional integration driven by unilateral facial efferent nerve dysfunction and to provide the theoretical foundation for the choice of suitable treatment strategy.Methods: Sixty-seven patients and 37 age-and sex-matched healthy controls were recruited to undergo resting-state functional magnetic resonance imaging (R-fMRI). Regional brain activity was analyzed by comparing the fractional amplitude of low-frequency fluctuations (fALFF) between right palsy and healthy control, left palsy and healthy control, and right and left palsy groups. The altered brain regions were further selected as seeds in subsequent functional connectivity (FC) analysis, and the correlations between the Toronto Facial Grading System (TFGS) scores and the connectivity alterations were also analyzed.Results: The right and left Bell's palsy groups showed fALFF alterations compared with the healthy control group, and several brain regions with different fALFF values between the right and left palsy groups were identified. In the right palsy group, overall inter-regional FC increased in the right supramarginal gyrus (SMG), bilateral superior frontal gyrus (SFG), and left precentral gyrus (PreCG), compared with the left palsy group. Furthermore, the brain region pairs with higher FC in the right palsy group were left temporal pole of the superior temporal gyrus (TPOsup) and right SMG, left TPOsup and middle cingulate cortex (MCC), left TPOsup and left PreCG, right SMG and SFG, MCC and left PreCG, left and right SFG, and right SFG and left PreCG. In the right palsy group, the left TPOsup and PreCG showed a negative correlation with the TFGS score, while the right SFG and left PreCG showed a positive correlation with the TFGS scores. In the left palsy group, the left TPOsup and right SMG, and the right SMG and SFG region pairs showed a negative correlation with the TFGS score.Conclusions: The fALFF and FC analyses revealed the remodeling of different brain functional networks driven by right or left facial nerve efferent dysfunction in patients with early Bell's palsy. The reintegration mechanisms differed between patients with right and left Bell's palsy. Additionally, the severity of the disease showed different associations with altered FC.