Dataset Information

Alteration of spatial patterns at the network-level in facial synkinesis: an independent component and connectome analysis.

ABSTRACT:

Background

The treatment of post-facial palsy synkinesis (PFPS) remains inadequate. Previous studies have confirmed that brain plasticity is involved in the process of functional restoration. Isolated activation has been well studied, however, the brain works as an integrity of several isolated regions. This study aimed to assess the alteration of the brain network topology with overall and local characteristics of information dissemination. Understanding the neural mechanisms of PFPS could help to improve therapy options and prognosis.

Methods

Patients with facial synkinesis and healthy controls (HCs) were estimated using functional magnetic resonance imaging (fMRI) of resting-state. Subsequently, an independent component analysis (ICA) was used to extract four subnets from the whole brain. Then we used the measurements of graph theory and calculated in the whole-brain network and each sub-network.

Results

We found no significant difference between the patient group and the HCs on the whole-brain scale. Then we identified four subnetworks from the resting-state data. In the sub-network property analysis, patients' locally distributed properties in the sensorimotor network (SMN) and ventral default mode network (vDMN) were reduced. It revealed that γ (10,000 permutations, P=0.048) and S (10,000 permutations, P=0.022) within the SMN progressively decreased in patients with PFPS. For the analysis of vDMN, significant differences were found in γ (10,000 permutations, P=0.019), Elocal (10,000 permutations, P=0.008), and β (10,000 permutations, P=0.011) between the groups.

Conclusions

Our results demonstrated a reduction in local network processing efficiency in patients with PFPS. Therefore, we speculate that decreased characteristics in the intra-vDMN and intra-SMN, rather than the whole-brain network, may serve distinct symptoms such as facial nerve damage or more synkinetic movements. This finding of the alteration of network properties is a small step forward to help uncover the underlying mechanism.

SUBMITTER: Ma ZZ

PROVIDER: S-EPMC7940883 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Alteration of spatial patterns at the network-level in facial synkinesis: an independent component and connectome analysis.

Ma Zhen-Zhen ZZ Lu Ye-Chen YC Wu Jia-Jia JJ Li Si-Si SS Ding Wei W Xu Jian-Guang JG

Annals of translational medicine 20210201 3

<h4>Background</h4>The treatment of post-facial palsy synkinesis (PFPS) remains inadequate. Previous studies have confirmed that brain plasticity is involved in the process of functional restoration. Isolated activation has been well studied, however, the brain works as an integrity of several isolated regions. This study aimed to assess the alteration of the brain network topology with overall and local characteristics of information dissemination. Understanding the neural mechanisms of PFPS co ...[more]

PMID: 33708867

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Project description:ImportanceIn the last decade, there has been a significant increase in the number of practitioners administering botulinum toxin for facial synkinesis. However, there are few resources available to guide treatment patterns, and little is known about how these patterns are associated with functional outcomes and quality of life.ObjectiveTo evaluate botulinum treatment patterns, including the dosing and frequency of muscle targeting, for treatment of facial synkinesis and to quantify patient outcomes.Design, setting, and participantsThis prospective cohort study of 99 patients treated for facial synkinesis was conducted from January 2016 through December 2018 at the Vanderbilt Bill Wilkerson Center in Nashville, Tennessee, a tertiary referral center.InterventionOnabotulinum toxin A treatment of facial synkinesis.Main outcomes and measuresPatient-reported outcomes on the Synkinesis Assessment Questionnaire and botulinum treatment patterns, including the dosages and frequency of injection for each facial muscle, were compared at the initiation of treatment and at the end of recorded treatment.ResultsIn total, 99 patients (80 female patients [81%]) underwent botulinum injections for treatment of facial synkinesis. The median (interquartile range) age was 54.0 (43.5-61.5) years, and the median (interquartile range) follow-up was 27.1 (8.9-59.7) months. Most patients underwent injections after receiving a diagnosis of Bell palsy (41 patients, 41%) or after resection of vestibular schwannoma (36 patients [36%]). The patients received a total of 441 treatment injections, and 369 pretreatment and posttreatment Synkinesis Assessment Questionnaire scores were analyzed. The mean botulinum dose was 2 to 3 U for each facial muscle and 9 to 10 U for the platysma muscle. The dose increased over time for the majority of all muscles, with steady state achieved after a median of 3 treatments (interquartile range, 2-3). Linear regression analysis for cluster data of the mean total questionnaire score difference was -14.2 (95% CI, -17.0 to -11.5; P < .001). There was a significant association of postinjection questionnaire score with younger patients, female sex, total dose, and synkinesis severity. Oculo-oral synkinesis may respond more to treatment compared with oro-ocular synkinesis.Conclusion and relevancePatients with facial synkinesis responded significantly to botulinum treatment. Treatment began with 6 core facial muscles that were injected during most treatment sessions, and dosages increased after the first injection until steady state was achieved. Those with a greater degree of morbidity, younger patients, and females showed significant improvement, and the larger the dose administered, the greater the response. Oculo-oral synkinesis may be more responsive than oro-ocular synkinesis.Level of evidence3.

Project description:Background: There is no current standard for facial synkinesis rehabilitation programs. The benefit and stability of effect of an intensified 10-day facial training combining electromyography and visual biofeedback training was evaluated. Methods: Fifty-four patients (77.8% female; median age: 49.5 years) with post-paralytic facial synkinesis (median time to onset of paralysis: 31.1 months) were included in retrospective longitudinal study between January 2013 and June 2016. Facial function was assesses at baseline (T0), first days of training (T1), last day of training (T2), and follow-up visit (T3) at a median time of 6 months later using the House-Brackmann (HB) facial nerve grading system, Stennert index (SI), Facial Nerve Grading System 2.0 (FNGS 2.0), and Sunnybrook Facial Grading System (SFGS). Pairwise comparisons between the time points with post-hoc Bonferroni correction were performed. Results: No significant changes of the gradings and subscores were seen between T0 and T1 (all p > 0.01). The 10-day combined and intensified feedback training between T1 and T2 improved facial symmetry and decreased synkinetic activity. Facial grading with the FNGS 2.0 or the SFGS were most suited to depict the training effect. FNGS 2.0, regional score, FNGS 2.0, synkinesis score, and FNGS 2.0 total score improved significantly (all p ≤ 0.0001). Both, the FNGS 2.0 and the SFGS showed the strongest improvement in the nasolabial fold/zygomatic and the oral region. Neither the age of the patient (r = 0.168; p = 0.224), the gender (r = 0.126; p = 0.363) nor the length of the interval between onset of the palsy and training start (r = 0.011; p = 0.886) correlated with the changes of the SFGS between T1 and T2. The results remained stable between T2 and T3 without any further significant change. Conclusion: Intensified daily combined electromyography and visual biofeedback training over 10 days was effective in patients with facial synkinesis and benefits were stable 6 months after therapy.

Dataset Information

Alteration of spatial patterns at the network-level in facial synkinesis: an independent component and connectome analysis.

Background

Methods

Results

Conclusions

Publications

Alteration of spatial patterns at the network-level in facial synkinesis: an independent component and connectome analysis.

Similar Datasets

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