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Abstract Details

Neural Responses Are Abnormal During Reflexive Blinking in Blepharospasm: An Event-Related fMRI Study
Movement Disorders
P4 - Poster Session 4 (5:30 PM-6:30 PM)
10-005
 Use functional MRI (fMRI) to investigate the neural mechanisms underlying reflexive blinking in blepharospasm (BSP) patients compared to healthy controls (HC).
Blepharospasm (BSP) is an isolated focal dystonia characterized by increased blinking and involuntary muscle spasms of the eyelid. While the etiology of BSP remains unknown, many studies suggest it is associated with dysregulated inhibition and abnormal sensorimotor integration.
15 BSP patients and 15 HC were recruited. Randomly timed air-puffs to the left eye were used to induce reflexive eye blinks during an 8-min fMRI scan. Continuous surface electromyography and video recordings were used to monitor blink responses. Data were analyzed using an event-related design with SPM12. Significance for voxel-wise analysis was defined as p < 0.05, corrected for multiple comparisons using the autocorrelation function approach incorporated into the 3dClustSim function in AFNI.

Data from one BSP subject was excluded due motion artifact. Data from 15 HC (11F, age 60.9 +/- 5.5) were compared to that of 14 BSP (10F, 61.6 +/- 8.0). Reflexive eye blinks in HC were associated with activation of the right anterior cingulate and left insular cortices. Compared to HC, BSP patients showed increased activation in the right post-central gyrus, left precentral gyrus, and left occipital cortex. BSP disease duration negatively correlated with reflexive-blink activity in the cerebellum and in the right temporal gyrus. Disease severity (Jankovic Rating Scale) negatively correlated with activity in the dorsal pons and left occipital cortex.
Reflexive blinking in BSP is associated with increased activation in sensorimotor cortices suggesting a loss of inhibition within the sensorimotor network. Decline in cerebellar activity with disease duration suggests an adaptive role, while reduced response during reflexive blinking in the pons with increasing disease severity suggests that changes in the corneal blink reflex circuitry are linked to the manifestation of symptoms.
Authors/Disclosures
Phuong Nguyen (University of Colorado School of Medicine)
PRESENTER 		No disclosure on file
No disclosure on file
Erika Shelton No disclosure on file
Brian Berman, MD, MS, FAAN (Virginia Commonwealth University) The institution of Dr. Berman has received research support from Dystonia Medical Research Foundation. The institution of Dr. Berman has received research support from National Institutes of Health. The institution of Dr. Berman has received research support from Neurocrine Biosciences. The institution of Dr. Berman has received research support from Benign Essential Blepharospasm Research Foundation. The institution of Dr. Berman has received research support from National Institutes of Health.