Abstract
Several studies have demonstrated through resting-state functional magnetic resonance imaging (fMRI) that functional connectivity changes are important in the recovery from Bell’s palsy (BP); however, these studies have only focused on the cortico-cortical connectivity. It is unclear how corticostriatal connectivity relates to the recovery process of patients with BP. In the present study, we evaluated the relationship between longitudinal changes of caudate-based functional connectivity and longitudinal changes of facial performance in patients with intractable BP. Twenty-one patients with intractable BP underwent resting-state fMRI as well as facial behavioral assessments prior to treatment (PT) and at the middle stage of treatment (MT); and 21 age- and sex-matched healthy controls (HC) were recruited and received the same protocol. The caudate was divided into dorsal and ventral sub-regions and separate functional connectivity was calculated. Compared with HC, patients with intractable BP at the PT stage showed decreased functional connectivity of both the dorsal and ventral caudate mainly distributed in the somatosensory network, including the bilateral precentral gyrus (MI), left postcentral gyrus, media frontal gyrus, and superior temporal gyrus (STG). Alternatively, patients in the MT stage showed decreased functional connectivity primarily distributed in the executive network and somatosensory network, including the bilateral cingulate cortex (CC), left anterior cingulate cortex (LACC), inferior prefrontal gyrus (IFG), MI, STG, and paracentral lobe. The longitudinal changes in functional connectivity of both the dorsal and ventral caudate were mainly observed in the executive network, including the right ACC, left CC, and IFG. Functional connectivity changes in the right ACC and left IFG were significantly correlated with changes in facial behavioral performance. These findings indicated that corticostriatal connectivity changes are associated with recovery from BP.
Highlights
Bell’s palsy (BP) is a common disorder caused by an idiopathic peripheral facial paralysis; patients generally completely recover within 6 months without requiring medication (Engström et al, 2008)
We found that significantly decreased functional connectivity of the dorsal caudate was mainly distributed in the executive network in patients with BP at the middle stage of treatment (MT) stage, including the bilateral anterior cingulate cortex (ACC), cingulate cortex (CC) and left inferior prefrontal gyrus (IFG), whereas decreased functional connectivity of the ventral caudate was mainly distributed in the left IFG
The present study investigated the longitudinal functional connectivity changes of the caudate in patients with intractable BP
Summary
Bell’s palsy (BP) is a common disorder caused by an idiopathic peripheral facial paralysis; patients generally completely recover within 6 months without requiring medication (Engström et al, 2008). Several studies have demonstrated that functional connectivity changes are associated with the functional improvements of the facial nerve during the course of BP rehabilitation. A single-case study has demonstrated that in a patient with BP, recovery from facial nerve palsy was complemented by cortical reorganization (Klingner et al, 2012). The functional connectivity strength of the ACC has been shown to enhance the prolonged concomitant course of disease (Hu et al, 2015). These studies have only focused on functional connectivity within the cerebral cortex and little is known about how changes of functional connectivity in subcortical regions, such as the basal ganglia nucleus, are related to patients’ recovery from BP
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