title: Glucose hypermetabolism in the thalamus of patients with hemifacial spasm.
abstract: The purpose of this study was investigate functional alteration in the brains of patients with hemifacial spasm using positron emission tomography (PET). We studied cerebral glucose metabolism using PET with (18) F-fluorodeoxyglucose in 13 patients with right lateral hemifacial spasm and 13 with left lateral hemifacial spasm. All patients underwent 2 PET scans before treatment (active state) and after treatment (suppressive state) with the botulinum neurotoxin type A. At the time of the PET scans, the severity of the spasm was rated according to the Jankovic Disability Rating Scale. We also used magnetic resonance imaging to evaluate the grade of neurovascular compression in each patient using scores of 1 to 3 (1 = mild, 3 = severe). Fifty-two normal volunteers were examined as controls. Compared with controls, patients with right and left hemifacial spasm showed bilateral cerebral glucose hypermetabolism in the thalamus in both the active and suppressive states. However, thalamic glucose metabolism after the suppressive state was significantly reduced compared with that in the active state using region of interest analysis. There was a positive correlation between the severity of the spasm in the active state and the score of neurovascular compression (rs = 0.65) that was estimated using Spearman order correlation coefficient. We observed bilateral cerebral glucose hypermetabolism in the thalamus of patients with hemifacial spasm. The thalamic glucose hypermetabolism may be attributed to multiple sources, including afferent input from the skin and muscle spindle, antidromic conduction of the facial nerve, and secondary alteration in the central nervous system.
authors.affiliation: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Itabashi, Tokyo, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimizu
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kiyosawa
authors.forename: Masato
authors.initials: M
authors.lastname: Wakakura
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishii
authors.forename: Kiichi
authors.initials: K
authors.lastname: Ishiwata
authors.forename: Manabu
authors.initials: M
authors.lastname: Mochizuki
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use; D004185:Disability Evaluation; D004576:Electromyography; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality / Q000187:drug effects / Q000502:physiology*; D005947:Glucose / Q000378:metabolism*; D019569:Hemifacial Spasm / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D013788:Thalamus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism*
chemical_list: D009465:Neuromuscular Agents; D019788:Fluorodeoxyglucose F18; D019274:Botulinum Toxins, Type A; D005947:Glucose