Abstract
Primary blepharospasm (BPS) is a focal dystonia characterized by involuntary blinking and eyelid spasms. The pathophysiology of BPS remains unclear. Several neuroimaging studies have suggested dysfunction of sensory processing and sensorimotor integration, but the results have been inconsistent. This study aimed to determine whether patients with BPS exhibit altered functional brain connectivity and to explore possible correlations between these networks and clinical variables. Twenty-five patients with BPS and 25 healthy controls were enrolled. We found that the patient group exhibited decreased connectivity within the sensory-motor network (SMN), which involved regions of the bilateral primary sensorimotor cortex, supplementary motor area (SMA), right premotor cortex, bilateral precuneus and left superior parietal cortex. Within the right fronto-parietal network, decreased connections were observed in the middle frontal gyrus, dorsal lateral prefrontal cortex and inferior frontal gyrus. Regarding the salience network (SN), increased connectivity was observed in the left superior frontal gyrus and middle frontal gyrus. These findings suggest the involvement of multiple neural networks in primary BPS.
Highlights
Primary blepharospasm (BPS) is a type of focal dystonia that is characterized by persistent or intermittent excessive involuntary blinking and eyelid spasms and has a disabling effect on work and everyday activities and may cause social embarrassment and catastrophic traffic accidents
There were no significant differences in the demographic variables between the patients with BPS and the healthy controls (HCs)
We explored four other RSNs that were derived from Smith et al (2009), i.e., the salience network (SN), the left frontoparietal network (LFPN), the auditory network (AN) and the primary visual network (PVN) and applied an AlphaSim corrected p < 0.05
Summary
Primary blepharospasm (BPS) is a type of focal dystonia that is characterized by persistent or intermittent excessive involuntary blinking and eyelid spasms and has a disabling effect on work and everyday activities and may cause social embarrassment and catastrophic traffic accidents. Recent magnetic resonance imaging (MRI) and electroneurophysiology studies have mapped selected components of neural networks in patients with BPS, with the cumulative evidence suggesting that BPS may represent a network disorder (Dresel et al, 2011; Suzuki et al, 2011; Battistella et al, 2017). Task-related network changes in BPS were related to the sensorimotor network (SMN), including the primary and secondary somatosensory regions (Dresel et al, 2011). Another study examining resting state networks in patients with BPS suggested decreased functional connection within the sensorimotor and frontoparietal networks (Battistella et al, 2017)
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