Wang Binbin, Ling Miao, Guo Chao, Sun Shengqiao, Zhang Xingnan, Hu Chenhao, Liu Hanjie, Li Dezhi, Schumacher Michael, Sui Binbin, Liu Song
Beijing Key Laboratory of Central Nervous System Injury, Beijing Neurosurgical Institute, Capital Medical University, Beijing 10070, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 10070, China.
Brain Res. 2025 Feb 15;1849:149437. doi: 10.1016/j.brainres.2024.149437. Epub 2024 Dec 28.
Peripheral nerve injury results in functional alterations of the corresponding active brain areas, which are closely related to functional recovery. Whether such functional plasticity induces relative anatomical structural changes remains to be investigated.
In this study, we investigated the changes in brain cortical thickness in patients with facial paralysis following neurorrhaphy treatment at different follow-up times. Using magnetic resonance imaging (MRI) and the CAT12 toolbox, voxel-based whole-brain morphometric (VBM) analysis and region of interest (ROI) of cortical thickness estimation were performed in 11 patients with left facial paralysis before and after hypoglossal-facial nerve neurorrhaphy, and the results were compared to those of 20 healthy controls. All subjects were right-handed and had a left dominant hemisphere. Based on the ROIs, correlation analysis among the cortical structural changes, the House-Brackmann (H-B) grading scale and the compound muscle action potential (cMAP) amplitudes of the facial paralyzed/reinnervated muscles in the patients was conducted.
The results show dynamic changes in the thickness in the contralateral right cortex at corresponding functional areas in patients. The thickness of the ROIs was negatively correlated with the duration of facial paralysis from onset to neurorrhaphy but was positively correlated with the improvement in H-B grades and cMAP wave amplitudes recorded in the paralyzed/reinnervated facial muscles of patients. Interestingly, a significant increase in cortical thickness was observed in the ipsilateral left cortex of patients before surgery. However, the increased thickness of the left cortex was then gradually decreased and returned to the reference level of healthy controls following neurorrhaphy and reinnervation of paralyzed facial muscles.
We concluded that dynamic changes in both sides of the brain cortex could reflect the state and effect of functional recovery in patients from the onset of facial paralysis before treatment to reinnervation and the return of lost function following neurorrhaphy, suggesting potential observation and treatment targets to predict prognosis and further promote functional recovery.
周围神经损伤会导致相应活跃脑区的功能改变，这与功能恢复密切相关。这种功能可塑性是否会引起相对的解剖结构变化仍有待研究。
在本研究中，我们调查了面神经吻合术后不同随访时间的面瘫患者脑皮质厚度的变化。使用磁共振成像（MRI）和CAT12工具箱，对11例左侧面瘫患者在舌下-面神经吻合术前、后的基于体素的全脑形态计量学（VBM）分析和皮质厚度估计的感兴趣区域（ROI）进行了研究，并将结果与20名健康对照者的结果进行了比较。所有受试者均为右利手且左半球占优势。基于ROI，对患者皮质结构变化、House-Brackmann（H-B）分级量表以及面瘫/再支配肌肉的复合肌肉动作电位（cMAP）振幅进行了相关性分析。
结果显示患者对侧右皮质相应功能区厚度的动态变化。ROI的厚度与面瘫从发病到神经吻合的持续时间呈负相关，但与患者面瘫/再支配面部肌肉中记录的H-B分级改善和cMAP波幅呈正相关。有趣的是，术前患者同侧左皮质的皮质厚度显著增加。然而，左皮质增加的厚度随后逐渐减小，并在神经吻合和面瘫肌肉再支配后恢复到健康对照者的参考水平。
我们得出结论，脑皮质两侧的动态变化可以反映面瘫患者从治疗前发病到神经吻合以及再支配和神经吻合后功能恢复的功能恢复状态和效果，提示了预测预后和进一步促进功能恢复的潜在观察和治疗靶点。
