Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.

Benign Essential Blepharospasm (BEB) and hemifacial spasm (HFS) are the most common hyperkinetic movement disorders of facial muscles. Although similar in clinical presentation different pathophysiological mechanisms are assumed. Botulinum Neurotoxin (BoNT) is a standard evidence-based treatment for...

Full description

Bibliographic Details
Main Authors: Hanganu Alexandru, Muthuraman Muthuraman, Venkata Chaitanya Chirumamilla, Nabin Koirala, Burcu Paktas, Günther Deuschl, Kirsten E Zeuner, Sergiu Groppa
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5161386?pdf=render
_version_ 1818953330138808320
author Hanganu Alexandru
Muthuraman Muthuraman
Venkata Chaitanya Chirumamilla
Nabin Koirala
Burcu Paktas
Günther Deuschl
Kirsten E Zeuner
Sergiu Groppa
author_facet Hanganu Alexandru
Muthuraman Muthuraman
Venkata Chaitanya Chirumamilla
Nabin Koirala
Burcu Paktas
Günther Deuschl
Kirsten E Zeuner
Sergiu Groppa
author_sort Hanganu Alexandru
collection DOAJ
description Benign Essential Blepharospasm (BEB) and hemifacial spasm (HFS) are the most common hyperkinetic movement disorders of facial muscles. Although similar in clinical presentation different pathophysiological mechanisms are assumed. Botulinum Neurotoxin (BoNT) is a standard evidence-based treatment for both conditions. In this study we aimed to assess grey matter microstructural differences between these two groups of patients and compared them with healthy controls. In patients we furthermore tracked the longitudinal morphometric changes associated with BoNT therapy. We hypothesized microstructural differences between the groups at the time point of maximum symptoms representation and distinct longitudinal grey matter dynamics with symptom improvement.Cross-sectional and longitudinal analyses of 3T 3D-T1 MRI images from BEB, HFS patients prior to and one month after BoNT therapy and from a group of age and sex matched healthy controls. Cortical thickness as extracted from Freesurfer was assessed as parameter of microstructural integrity.BoNT therapy markedly improved motor symptoms in patients with BEB and HFS. Significant differences of grey matter integrity have been found between the two patients groups. The BEB group showed lower cortical thickness at baseline in the frontal-rostral, supramarginal and temporal regions compared to patients with HFS. In this group BoNT treatment was associated with a cortical thinning in the primary motor cortex and the pre-supplementary motor area (pre-SMA). Contrary patients with HFS showed no longitudinal CT changes. A decreased cortical thickness was attested bilaterally in the temporal poles and in the right superior frontal region in BEB patients in comparison to HC. Patients in the HFS group presented a decreased CT in the left lingual gyrus and temporal pole.Although patients with BEB and HFS present clinically with involuntary movements of facial muscles, they exhibited differences in cortical thickness. While BoNT therapy was equally effective in both groups, widespread changes of cortical morphology occurred only in BEB patients. We demonstrated specific disease- and therapy-dependent structural changes induced by BoNT in the studied hyperkinetic conditions.
first_indexed 2024-12-20T10:04:33Z
format Article
id doaj.art-45bc931a35334727b5846a00b83b8cb3
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-20T10:04:33Z
publishDate 2016-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-45bc931a35334727b5846a00b83b8cb32022-12-21T19:44:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011112e016865210.1371/journal.pone.0168652Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.Hanganu AlexandruMuthuraman MuthuramanVenkata Chaitanya ChirumamillaNabin KoiralaBurcu PaktasGünther DeuschlKirsten E ZeunerSergiu GroppaBenign Essential Blepharospasm (BEB) and hemifacial spasm (HFS) are the most common hyperkinetic movement disorders of facial muscles. Although similar in clinical presentation different pathophysiological mechanisms are assumed. Botulinum Neurotoxin (BoNT) is a standard evidence-based treatment for both conditions. In this study we aimed to assess grey matter microstructural differences between these two groups of patients and compared them with healthy controls. In patients we furthermore tracked the longitudinal morphometric changes associated with BoNT therapy. We hypothesized microstructural differences between the groups at the time point of maximum symptoms representation and distinct longitudinal grey matter dynamics with symptom improvement.Cross-sectional and longitudinal analyses of 3T 3D-T1 MRI images from BEB, HFS patients prior to and one month after BoNT therapy and from a group of age and sex matched healthy controls. Cortical thickness as extracted from Freesurfer was assessed as parameter of microstructural integrity.BoNT therapy markedly improved motor symptoms in patients with BEB and HFS. Significant differences of grey matter integrity have been found between the two patients groups. The BEB group showed lower cortical thickness at baseline in the frontal-rostral, supramarginal and temporal regions compared to patients with HFS. In this group BoNT treatment was associated with a cortical thinning in the primary motor cortex and the pre-supplementary motor area (pre-SMA). Contrary patients with HFS showed no longitudinal CT changes. A decreased cortical thickness was attested bilaterally in the temporal poles and in the right superior frontal region in BEB patients in comparison to HC. Patients in the HFS group presented a decreased CT in the left lingual gyrus and temporal pole.Although patients with BEB and HFS present clinically with involuntary movements of facial muscles, they exhibited differences in cortical thickness. While BoNT therapy was equally effective in both groups, widespread changes of cortical morphology occurred only in BEB patients. We demonstrated specific disease- and therapy-dependent structural changes induced by BoNT in the studied hyperkinetic conditions.http://europepmc.org/articles/PMC5161386?pdf=render
spellingShingle Hanganu Alexandru
Muthuraman Muthuraman
Venkata Chaitanya Chirumamilla
Nabin Koirala
Burcu Paktas
Günther Deuschl
Kirsten E Zeuner
Sergiu Groppa
Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
PLoS ONE
title Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
title_full Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
title_fullStr Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
title_full_unstemmed Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
title_short Grey Matter Microstructural Integrity Alterations in Blepharospasm Are Partially Reversed by Botulinum Neurotoxin Therapy.
title_sort grey matter microstructural integrity alterations in blepharospasm are partially reversed by botulinum neurotoxin therapy
url http://europepmc.org/articles/PMC5161386?pdf=render
work_keys_str_mv AT hanganualexandru greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT muthuramanmuthuraman greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT venkatachaitanyachirumamilla greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT nabinkoirala greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT burcupaktas greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT guntherdeuschl greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT kirstenezeuner greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy
AT sergiugroppa greymattermicrostructuralintegrityalterationsinblepharospasmarepartiallyreversedbybotulinumneurotoxintherapy