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. 2025 Jul 3:16:1583297.
doi: 10.3389/fneur.2025.1583297. eCollection 2025.

Comparative study of brain activity and functional connectivity in blepharospasm and blepharospasm-oromandibular dystonia

Yanying Wang #  1 , Min Luo #  1 , Bo Hou  2 , Yang Li  1 , Yingmai Yang  1 , Feng Feng  2 , Lin Wang  1 , Xinhua Wan  1
Affiliations

Comparative study of brain activity and functional connectivity in blepharospasm and blepharospasm-oromandibular dystonia

Yanying Wang et al. Front Neurol. .

Abstract

Background: The most common spread of blepharospasm (BSP) is to the oromandibular region, labeled as blepharospasm-oromandibular dystonia (BOM). We aimed to identify shared and different functional changes in BSP and BOM, trying to unveil the pathogenesis of these disorders and the mechanism of dystonic spread.

Materials and methods: This single center study recruited 16 BSP patients, 16 BOM patients and 20 healthy controls (HC). Clinical information and resting-state fMRI images were collected. Dynamic amplitude of low-frequency fluctuations (dALFF) was calculated using the sliding window method. Intergroup differences in static ALFF (sALFF) and dALFF were examined. Using dALFF results, seed-based static and dynamic functional connectivity (FC) were constructed to compare connectivity changes in BSP and BOM networks. Correlations between dynamic parameters and disease severity scores were analyzed using Spearman partial correlation.

Results: Compared with HC, BSP and BOM presented increased dALFF in the bilateral basal ganglia, bilateral supplementary motor area, right precentral gyrus, and bilateral cingulate gyrus. BOM further demonstrated decreased sALFF in the left cerebellum. Compared with HC, BOM patients had decreased sFC in the network involving the sensorimotor cortex, supplementary motor area, basal ganglia, cerebellum, and brainstem. In addition, decreased dFC strength was found between the right pallidum and cerebellum. Comparing with BSP patients, BOM patients showed decreased sFC and dFC strength in a similar but limited pattern. Clinical scores of BSP severity were significantly correlated with dALFF in some of these important regions.

Conclusions: Our results demonstrated common brain regions with impaired functional activity in BSP and BOM patients. Further, BOM is featured with widespread connectivity reduction in the sensorimotor cortico-basal ganglia-brainstem-cerebellar network deriving from these key regions. These findings could help investigate mechanisms of dystonia spread and potentially facilitate disease-modifying therapies.

Keywords: blepharospasm; blepharospasm-oromandibular dystonia; dynamic ALFF; dynamic FC; fMRI.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Four rows of brain imaging results comparing sALFF and dALFF in two conditions: BSP vs HC and BOM vs HC. Rows A and B depict sALFF results with highlighted areas in orange, red, and blue. Rows C and D show dALFF results with significant activation in red. A color bar on the right indicates statistical values. Images are labeled with slice positions (Z-coordinates) and lateral orientations.
Figure 1
Brain regions showing significant differences in sALFF and dALFF variance between groups. (A) sALFF differences between BSP and HC; (B) sALFF differences between BOM and HC; (C) dALFF differences between BSP and HC; (D) dALFF differences between BOM and HC. Color bar indicates range of t-values. L, left; R, right.
Brain MRI images comparing different functional connectivity strengths. Panel A shows static functional connectivity (sFC) BOM vs HC with highlighted blue areas. Panel B displays sFC BOM vs BSP. Panel C presents dynamic functional connectivity (dFC) strength BOM vs HC. Panel D shows dFC strength BOM vs BSP. Color bars indicate significance levels ranging from -3 to approximately -6.73, with specific Z-slice levels noted.
Figure 2
Brain regions showing significant differences in sFC and dFC strength with right precentral gyrus between groups. (A) Decreased sFC between BOM and HC; (B) Decreased sFC between BOM and BSP; (C) Decreased dFC strength between BOM and HC; (D) Decreased dFC strength between BOM and BSP. Color bar indicates range of t-values. L, left; R, right.
Brain MRI scans show functional connectivity comparisons in different regions: panels A and B depict left supplementary motor area analysis between BOM vs HC; panels C and E illustrate right pallidum analysis for BOM vs HC; panels D and F show right pallidum comparison for BOM vs BSP. Blue color indicates significant areas of interest at various Z and X coordinates, with color scales denoting statistical values.
Figure 3
Brain regions showing significant differences in sFC and dFC strength with left SMA and right pallidum between groups. (A) Decreased sFC with left SMA between BOM and HC; (B) Decreased dFC strength with left SMA between BOM and HC; (C) Decreased sFC with right pallidum between BOM and HC. (D) Decreased sFC with right pallidum between BOM and BSP; (E) Decreased dFC with right pallidum between BOM and HC. (F) Decreased dFC with right pallidum between BOM and BSP. Color bar indicates range of t-values. L, left; R, right.
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