Abnormal brain white matter in patients with hemifacial spasm: a diffusion tensor imaging study

Refractory hemifacial contraction and comorbid emotional disorders are major annoyance suffered by patients with hemifacial spasm (HFS). It is currently unknown how whiter matter (WM) abnormalities in the brain contribute to HFS.

To investigate WM alterations in HFS, 26 patients and 29 matched healthy controls were ultimately recruited in this experiment. The whole brain diffusion tensor imaging (DTI) was acquired at 3.0 Tesla scanner. Tract-based spatial statistics (TBSS) analysis was applied to investigate the differences of DTI metrics (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) axial diffusivity (AD)) between HFS patients and controls throughout brain WM. The relationship between the severity of facial spasm and affective disturbance in HFS patients, and WM abnormalities was examined using spearman correlation analyses.

TBSS method showed structural alterations in the genu and body of corpus callosum; bilateral inferior longitudinal fasciculus (ILF) and inferior frontal-occipital fasciculus (IFOF); left superior longitudinal fasciculus, anterior, posterior, and superior portion of corona radiata; left posterior limb of the internal capsule; and left posterior thalamic radiation in HFS patients compared with healthy subjects. In addition, the overlapped region of decreased FA together with increased RD and MD was merely localized in the right ILF and IFOF in the HFS group, and abnormality of RD value in this region was positively correlated with the patients' spasm score.

The present study indicate extensive disruptions of WM integrity, especially the RD changes in right ILF and IFOF, which may provide alternative imaging clues for evaluating the characteristics of HFS.