眼睑痉挛
灰质
心理学
基底神经节
神经科学
基于体素的形态计量学
面肌痉挛
辅助电机区
舌回
运动障碍
磁共振成像
听力学
白质
功能磁共振成像
医学
病理
内科学
疾病
放射科
中枢神经系统
肌张力障碍
面神经
作者
Jinping Xu,Yuhan Luo,Kangqiang Peng,Yaomin Guo,Liting Zhong,Ying Liu,Ai Weng,Zilin Ou,Zhicong Yan,Ying Wang,Jinsheng Zeng,Weixi Zhang,Qingmao Hu,Gang Liu
出处
期刊:Brain
[Oxford University Press]
日期:2022-09-21
卷期号:146 (4): 1542-1553
被引量:7
标识
DOI:10.1093/brain/awac341
摘要
Abstract Blepharospasm is traditionally thought to be a movement disorder that results from basal ganglia dysfunction. Recently, accumulating morphometric studies have revealed structural alterations outside the basal ganglia, such as in the brainstem, cerebellum and sensorimotor cortex, suggesting that blepharospasm may result from network disorders. However, the temporal and causal relationships between structural alterations and whether there are disease duration-related hierarchical structural changes in these patients remain largely unknown. Structural MRI was performed in 62 patients with blepharospasm, 62 patients with hemifacial spasm and 62 healthy controls to assess the structural alterations using voxel-based morphology and structural covariance networks. The use of the causal structural covariance network, modularity analysis and functional decoding were subsequently performed to map the causal effect of grey matter change pattern, hierarchical topography and functional characterizations of the structural network throughout the disease duration of blepharospasm. Greater grey matter volume in the left and right supplementary motor areas was identified in patients with blepharospasm compared to that in patients with hemifacial spasm and healthy controls, whereas no significant difference was identified between patients with hemifacial spasm and healthy controls. In addition, increased grey matter volume covariance between the right supplementary motor area and right brainstem, left superior frontal gyrus, left supplementary motor area and left paracentral gyrus was found in patients with blepharospasm compared to healthy controls. Further causal structural covariance network, modularity analysis and functional decoding showed that the right supplementary motor area served as a driving core in patients with blepharospasm, extending greater grey matter volume to areas in the cortico-basal ganglia–brainstem motor pathway and cortical regions in the vision–motor integration pathway. Taken together, our results suggest that the right supplementary motor area is an early and important pathologically impaired region in patients with blepharospasm. With a longer duration of blepharospasm, increased grey matter volume extends from the right supplementary motor area to the cortico-basal ganglia motor and visual–motor integration pathways, showing a hierarchy of structural abnormalities in the disease progression of blepharospasm, which provides novel evidence to support the notion that blepharospasm may arise from network disorders and is associated with a wide range of grey matter abnormalities.
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