Accepted Manuscript Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve Javier Buendia, MD, Francis R. Loayza, PhD, Elkin O. Luis, MSc, Marta Celorrio, Maria A. Pastor, MD, PhD, Bernardo Hontanilla, MD, PhD PII:

S1748-6815(15)00517-3

DOI:

10.1016/j.bjps.2015.10.033

Reference:

PRAS 4808

To appear in:

Journal of Plastic, Reconstructive & Aesthetic Surgery

Received Date: 19 May 2015 Revised Date:

7 September 2015

Accepted Date: 21 October 2015

Please cite this article as: Buendia J, Loayza FR, Luis EO, Celorrio M, Pastor MA, Hontanilla B, Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve, British Journal of Plastic Surgery (2015), doi: 10.1016/j.bjps.2015.10.033. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve

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List of Authors: Javier Buendia MDa* Francis R. Loayza, PhDbc§*

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Elkin O. Luis MScb,c Marta Celorriob,c

Bernardo Hontanilla MD, PhDa ** a

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Maria A. Pastor, MD, PhDb,c**

Plastic and Reconstructive Surgery Department, Clinica Universidad de Navarra, University of Navarra, 31008 Pamplona, Spain

b

Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of

Navarra, 31008 Pamplona, Spain. c

CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain

§

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F. Loayza actual affiliation: Neuroimaging and Bioengineering Laboratory, Faculty of Mechanical Engineering, Littoral Polytechnic University (ESPOL), EC090112, Guayaquil, Ecuador.

*Both authors contributed equally to this article.

** Both authors are considered corresponding authors.

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Corresponding Authors:

Bernardo Hontanilla MD, PhD

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Plastic Surgery Department, Clinica Universidad de Navarra, University of Navarra. C/Pío XII 36, 31008 Pamplona, Spain. [email protected]

Maria A. Pastor MD, PhD Functional Neuroimaging Laboratory, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain. [email protected]

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ACCEPTED MANUSCRIPT SUMMARY

Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is used to restore the smile, some

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controversy appears because of the non-physiological mechanism of smile recovering. Different authors have reported natural results with the masseter nerve. The physiological pathways which determine whether this is achieved remain unclear.

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Brain activation pattern measuring Blood-Oxygen-Level-Dependent (BOLD) signal during smiling and jaw-clenching was recorded in a group of 24 healthy subjects (11

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females) using functional magnetic resonance imaging. Effective connectivity of premotor regions was also compared in both tasks.

The brain activation pattern was similar for smile and jaw-clenching tasks. Smile activations showed topographic overlap though more extended for smile than clenching.

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Gender comparisons during facial movements, according to kinematics and BOLD signal, did not reveal significant differences. Effective connectivity results of Psycophysiological interaction (PPI) from the same seeds located in bilateral facial

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premotor regions showed significant task and gender differences (p Smile. p Smile

Bilateral ACC extended to Orbital and -11

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1541

Caudate nucleus Right Middle Frontal Gyrus

1200 42

48

6

4.63

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Table 2. Conjunction analysis between the two conditions Smile and Jaw-clenching.

Region

MNI Coordinates

Stats.

Cluster

X

t value

size

Y

Bilateral Cerebellum:

Bilateral Basal Ganglia:

-58

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29

Z

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Smile - Jaw-clenching

Lobule VI and VIII

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Overlapped regions - Smile and Jaw-clenching (Conjunction analysis)

-23

13.16

23442

-23

-4

9

7.59

-26

-4

-8

8.09

-54

-7

43

11.37

5060

Right Postcentral gyrus (facial MI)

57

-7

42

7.95

2892

Supplementary Motor Area

-2

-1

60

9.25

2858

Left Superior Temporal Gyrus

-48

-34

21

7.64

1759

Right Superior Temporal Gyrus

47

-33

21

4.67

338

Thalamus and Putamen Bilateral Amygdala

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Left Postcentral gyrus (facial MI)

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Effective connectivity PPI results Changes in connectivity from seed located on facial MI MNI Coordinates

Stats.

Cluster

X

t value

size

Y

Z

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Region

Increases in connectivity during Jaw-clenching compared to Smile Right Inferior Frontal (p. Triangularis)

41

30

35

38

4.93

18

4.46

655

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Right Middle Frontal

13

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Increases in connectivity during Smile compared to Jaw-clenching Left Inferior Frontal (p. Orbitalis)

-51

32

-6

4.48 389

Left Inferior Frontal (p. Triangularis)

26

6

3.99

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-56

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Gender differences in effective connectivity during Smile and Jaw-Clenching tasks

Bilateral periacueductal grey

6

-24

-11 6.14

-22

-12

Left Thalamus prefrontal

-12

-7

12

5.41

Left Thalamus parietal

-21

-10

19

4.73

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-3

752

643 Left Thalamus Temporal

-11

-24

12

4.66

Left Thalamus premotor

-17

-13

4

3.47

Right Thalamus prefrontal

20

-10

16

5.58

489

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ACCEPTED MANUSCRIPT

Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve.

Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is u...
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