To study the neuroplasticity of the brain due to facial synkinesis by assessing the somatotopy of the face on several cortexes of interest (primary and secondary somatosensory cortexes, the primary motor cortex, the supplementary motor cortex, the…
ID
Source
Brief title
Condition
- Peripheral neuropathies
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main study parameter is the hemodynamic response after stimulation of
specific parts of the face. Within the areas of interest (primary motor cortex,
the ventral lateral premotor cortex, the supplementary motor cortex, the
primary somatosensory cortex (S1), the secondary somatosensory cortex (S2), the
facial nucleus (pons), and the trigeminal nucleus (pons)), the temporo-spatial
brain activity patterns after the different motor and sensory tasks are
assessed, and the representation of the face is mapped on the cortexes of
interest.
Secondary outcome
not applicable
Background summary
Facial synkinesis is one of the most common consequences after facial
paralysis, defined as the inability to move muscles due to nerve damage. Facial
synkinesis arises during recovery of nerve injury and is characterized by
involuntary and synchronous contractions of muscles during facial movements.
Patients* quality of life is major influenced by the disease. As patients
experience problems with facial movements, this leads to difficulties in
expressing emotions, eating, and drinking.
A common type of facial synkinesis is oral-ocular synkinesis, defined as eye
closure during movement with the mouth. During movements of the mouth, the
buccinator muscle plays an essential role. Both the trigeminal and the facial
nerve innervate the buccinator muscle, resulting in a complex sensorimotor
feedback system between the nerves. Dysregulation of this feedback system is
assumed to result in hyperexcitability of the trigeminal and facial nuclei in
the pons. In addition, this will lead to cortical plasticity of the sensory and
motor areas of the brain. Based on this, we hypothesize dysregulation of the
sensorimotor feedback system in patients with facial synkinesis, resulting in
differences in the neuroplastic organization of the primary and secondary
somatosensory cortexes, the primary motor cortex, the supplementary motor
cortex, and the ventral lateral premotor cortex compared to healthy control
participants. In addition, we expect hyperexcitability of the trigeminal and
facial nuclei. Therefore, this study aims to obtain a more detailed
understanding of the neural reorganization of the sensory and motor areas as a
consequence of facial synkinesis using 7T fMRI.
Study objective
To study the neuroplasticity of the brain due to facial synkinesis by assessing
the somatotopy of the face on several cortexes of interest (primary and
secondary somatosensory cortexes, the primary motor cortex, the supplementary
motor cortex, the ventral lateral premotor cortex, the facial nucleus (pons)
and the trigeminal nucleus (pons)) compared to healthy control participants.
Study design
A single center imaging study carried out in MUMC+. Every subject will undergo
a single functional MRI scan in the 7 Tesla MRI scan of Scannexus. A scanning
session takes approximately 1.5 hours. During the scan, participants are asked
to perform motor and sensory tasks.
Study burden and risks
All subjects with facial synkinesis will be informed of the study by their
treating physicians at the outpatient clinic of plastic surgery. If they
express interest in the study they will be approached by the study group.
The potential participants will be informed about the study and the procedures,
and the subject information and consent form are handed out. If patients are
willing to participate, an appointment is made with the researcher to sign the
consent form.
On a later moment every subject will undergo a single functional MRI scan
taking 1.5 hours. There are no follow-up moments. Subjects do not have any
direct benefits in participating in the study. In the rare case an anomaly is
identified on any of the fMRI images, this will be discussed with the subject
and this information is shared with the general practitioner. The burden
associated with participation in this study, involves the usual MRI side
effects (e.g. anxious or claustrophobic feelings). No radiation is involved.
P.Debyelaan 25
Maastricht 6229HX
NL
P.Debyelaan 25
Maastricht 6229HX
NL
Listed location countries
Age
Inclusion criteria
(1) absence of facial nerve transposition; (2) participants must be 18 years of
age or older; (3) signed informed consent.
For patients who suffer from oral-ocular synkinesis, two extra criteria will be
maintained: patients must have severe facial synkinesis based on the Sunnybrook
facial grading system at the time the MRI scan is performed, and synkinesis
must occur only on one side of the face.
Exclusion criteria
The following exclusion criteria will be maintained for both the patients with
facial synkinesis as the control participants: previous neurosurgery and
contraindications for MRI investigation, such as a pacemaker, implanted pumps
or stimulators, iron materials (e.g., piercings), facial tattoos and permanent
make up, or claustrophobia.
For control participants, one extra criteria will be maintained: the
participant must have no forms of facial paralysis prior to the MRI examination
and at the time of the MRI procedure.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL78991.068.21 |