Central functional reorganization and recovery following facial-hypoglossal neurorrhaphy for facial paralysis

作者：Miao Ling, Binbin Sui, Diya Su, Dezhi Li, Binbin Wang, Hong Wan, Michaël Schumacher, Lanxin Ji, Song Liu · 发表于：NeuroImage Clinical · 年份：2021 · DOI：10.1016/j.nicl.2021.102782 · 被引用次数：15 · 研究领域：Facial Nerve Paralysis Treatment and Research、Trigeminal Neuralgia and Treatments、Ear Surgery and Otitis Media

OBJECTIVE: Functional deficits induced by nerve injuries can be restored by achieving effective reinnervation of the denervated targets and functional reorganization of the central nervous system after nerve reconstruction. In this study, we investigated the effect and extent of cortical functional reorganization related to the ability of transferred hypoglossal neurons to restore facial function in facial paralysis patients after a surgical bridge of neurorrhaphy ectopically between the ipsilateral hypoglossal nerve and injured facial nerve. METHODS: We treated 23 patients (35.4 ± 10.3 years, 10 males) and followed them up for 2.9 ± 0.61 years. We used motor-task-related functional magnetic resonance imaging to map activation change at multiple time points before and after neurorrhaphy; 20 normal subjects were included as control. RESULTS: All patients regained facial function to some extent after neurorrhaphy. Enhanced activation in motor-related cortices gradually returned to normal levels and was positively correlated with regained facial function. The related cortical functional areas included the left middle temporal gyrus, left inferior frontal gyrus, insula, bilateral motor cortex and the supplementary motor area extending to the paracingulate involved in intensive eye closing, as well as the left superior temporal gyrus, right putamen and the bilateral motor cortex involved in lip pursing. Intriguingly, significant correlations were found between the pre-surgery acti...