Clinical College, Jining Medical University.
Department of Radiology, The First People's Hospital of Jining, Jining, Shandong.
J Craniofac Surg. 2023;34(2):674-679. doi: 10.1097/SCS.0000000000009083. Epub 2022 Nov 21.
To analyze the changes in the white matter structure of the whole brain in hemifacial spasm (HFS) patients by using the tract-based spatial statistics (TBSS) method.
29 HFS patients without anxiety and depression and 29 healthy controls with matching age, sex, and education were selected. All subjects received a 3.0T magnetic resonance (MR) brain diffusion tensor imaging scan. Tract-based spatial statistics method was used to analyze the changes in white matter structure in the whole brain and obtained the cerebral white matter fibrous areas exhibiting significant intergroup differences. The fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity of these areas were abstracted. Analyzed the correlation between these diffusion metrics and clinical variables (disease duration, spasm severity).
Compared with the healthy controls group, the HFS group exhibited significantly lower FA in the forceps minor, bilateral anterior thalamic radiation, and right superior longitudinal fasciculus ( P <0.05, threshold-free cluster enhancement corrected). Cohen grading scale of HFS patients was negatively correlated with FA of forceps minor.
Based on TBSS analysis, the injury of white matter fiber tracts in HFS patients was found, including forceps minor, bilateral anterior thalamic radiation, and right superior longitudinal fasciculus. The changes of FA values in forceps minor were negatively correlated with the Cohen grading scale, suggesting that the alteration of white matter fiber in the genu-of-corpus-callosum-cortex circuit plays an important role in the neuro-pathological mechanism of HFS. Combined with previous research, it is also necessary to further explore the change of the superior longitudinal fasciculus in the future.
采用基于体素的空间统计学（TBSS）方法分析面肌痉挛（HFS）患者全脑白质结构的变化。
选取 29 例无焦虑和抑郁的 HFS 患者和 29 例年龄、性别和教育程度相匹配的健康对照者，所有受试者均接受 3.0T 磁共振（MR）脑弥散张量成像扫描。采用 TBSS 方法分析全脑白质结构变化，获得组间差异有统计学意义的脑白质纤维区域。提取这些区域的各向异性分数（FA）、平均弥散度、轴向弥散度和径向弥散度。分析这些扩散指标与临床变量（病程、痉挛严重程度）之间的相关性。
与健康对照组相比，HFS 组在右侧小内囊束、双侧内囊前辐射和右侧上纵束的 FA 值显著降低（P<0.05，经阈值自由聚类增强校正）。HFS 患者的 Cohen 分级量表与右侧小内囊束的 FA 值呈负相关。
基于 TBSS 分析发现 HFS 患者存在白质纤维束损伤，包括右侧小内囊束、双侧内囊前辐射和右侧上纵束。右侧小内囊束 FA 值的变化与 Cohen 分级量表呈负相关，提示胼胝体膝部-皮质环路白质纤维的改变在 HFS 的神经病理机制中起重要作用。结合既往研究，未来还需要进一步探索上纵束的变化。
