Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
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DOI：
10.1371/journal.pone.0168652
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Groppa S
中科院分区：
文献类型：
--
作者：
Alexandru H;Muthuraman M;Chirumamilla VC;Koirala N;Paktas B;Deuschl G;Zeuner KE;Groppa S
良性特发性眼睑痉挛（BEB）和面肌痉挛（HFS）是最常见的面部肌肉运动过度性疾病。尽管临床表现相似，但假设存在不同的病理生理机制。肉毒杆菌神经毒素（BoNT）是这两种疾病的标准循证治疗。在这项研究中，我们的目的是评估这两组患者之间的灰质微结构差异，并将其与健康对照组进行比较。在患者中，我们进一步追踪了与BoNT治疗相关的纵向形态学变化。我们假设组间在最大症状表现时间点的微结构差异和症状改善的明显纵向灰质动力学。对BEB、HFS患者BoNT治疗前和治疗后1个月以及年龄和性别匹配的健康对照组的3 T 3D-T1 MRI图像进行横截面和纵向分析。从Freesurfer中提取的皮质厚度被评估为微结构完整性的参数。BoNT治疗显著改善BEB和HFS患者的运动症状。两组患者的灰质完整性有显著差异。与HFS患者相比，BEB组在基线时额喙、边缘上和颞区的皮质厚度较低。在该组中，BoNT治疗与初级运动皮质和前补充运动区（pre-SMA）的皮质变薄相关。相反，HFS患者没有纵向CT改变。与HC相比，BEB患者双侧颞极和右侧上级额叶区域的皮质厚度减少。HFS组患者左侧舌回和颞极CT降低。虽然BEB和HFS患者临床上表现为面部肌肉的不自主运动，但他们的皮质厚度存在差异。虽然BoNT治疗在两组中同样有效，但仅在BEB患者中发生了广泛的皮质形态学变化。我们证明了特定的疾病和治疗依赖性的结构变化所诱导的BoNT在所研究的多动症的条件。
Benign Essential Blepharospasm (BEB) and hemifacial spasm (HFS) are the most common hyperkinetic movement disorders of facial muscles. Although similar in clinical presentation different pathophysiological mechanisms are assumed. Botulinum Neurotoxin (BoNT) is a standard evidence-based treatment for both conditions. In this study we aimed to assess grey matter microstructural differences between these two groups of patients and compared them with healthy controls. In patients we furthermore tracked the longitudinal morphometric changes associated with BoNT therapy. We hypothesized microstructural differences between the groups at the time point of maximum symptoms representation and distinct longitudinal grey matter dynamics with symptom improvement. Cross-sectional and longitudinal analyses of 3T 3D-T1 MRI images from BEB, HFS patients prior to and one month after BoNT therapy and from a group of age and sex matched healthy controls. Cortical thickness as extracted from Freesurfer was assessed as parameter of microstructural integrity. BoNT therapy markedly improved motor symptoms in patients with BEB and HFS. Significant differences of grey matter integrity have been found between the two patients groups. The BEB group showed lower cortical thickness at baseline in the frontal-rostral, supramarginal and temporal regions compared to patients with HFS. In this group BoNT treatment was associated with a cortical thinning in the primary motor cortex and the pre-supplementary motor area (pre-SMA). Contrary patients with HFS showed no longitudinal CT changes. A decreased cortical thickness was attested bilaterally in the temporal poles and in the right superior frontal region in BEB patients in comparison to HC. Patients in the HFS group presented a decreased CT in the left lingual gyrus and temporal pole. Although patients with BEB and HFS present clinically with involuntary movements of facial muscles, they exhibited differences in cortical thickness. While BoNT therapy was equally effective in both groups, widespread changes of cortical morphology occurred only in BEB patients. We demonstrated specific disease- and therapy-dependent structural changes induced by BoNT in the studied hyperkinetic conditions.
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影响因子：
5.7
作者：
Reuter, Martin;Schmansky, Nicholas J.;Rosas, H. Diana;Fischl, Bruce
通讯作者：
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DOI：
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