The Blepharospasm Baseline Brain Function-a Resting State-fMRI Study

Objective:Compare the different spontaneous brain activity between patients withblepharospasm and healthy controls by resting-state functional magnetic resonanceimaging（fMRI）-amplitude of low-frequency fluctuation（ALFF）method, and observethe brain baseline brain function change caused by peripheral botulinum toxin injection,in order to investigate the pathogenesis of blepharospasm and the effct of botulinumtoxin at the central nervous system.Method:10patients with blepharospasm and10healthy controls group matched by gender,age, educational level were scanned with signa3.0T MRI scanner(GE).6patientsaccepted the treatment of type A botulinum toxin and evalulated with JRS(JankovicRating Scale) were rescaned in40-60days after the injection. The image data wereanalyzed with software SPM8，DPAESF and REST. The activation maps within group aone sample t-test was used. And between group contrasts (blepharospasm paintientsand controls) a two sample t-test was used. The brain activation pattern alterationbetween pre and post treatment of A type botulinum toxin a paired samples t-test wasused.Results:1.As compared to the control group, the patients with blepharospasm exhibitedsignificant increased activities in the bilateral frontal gyrus, orbitofrontal gyrus, left M1,S1area, right front cingulate, right fusiform gyrus, decrereased in left supplementarymotor area, bilateral cuneus, left precentral lobule (P <0.05, Alphasinm positive).2. After botulinum toxin type A treatment showed no significant activities change except for the higher activation in bilateral parahippocampal gyrus, hippocampus, theleft medial cingulate next and posterior cingulated(P <0.05, Alphasinm positive).3. After BTX-A injection, the patients of blepharospasm with JRS scale score issignificantly lower than before treatment, the difference was statistically significant（P<0.001）.Conclusion1.There are multiple cortical dysfunction in blepharospasm include bilateral frontal,the major sensorimotor area, fusiform, suggesting that the plurality of cortical functionsthe anomaly directly or indirectly involved in the pathogenesis of blepharospasm.2. Botulinum toxin type A is not significantly affected cortical activity in patientswith blepharospasm.3. Botulinum toxin type A can significantly improve the clinical symptoms ofblepharospasm.