Open AccessOutcome‐dependent coactivation of lip and tongue primary somatosensory representation following hypoglossal–facial transfer after peripheral facial palsy
Author(s) -
Rottler Philipp,
Schroeder Henry W.S.,
Lotze Martin
Publication year - 2014
Publication title -
human brain mapping
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.005
H-Index - 191
eISSN - 1097-0193
pISSN - 1065-9471
DOI - 10.1002/hbm.22206
Subject(s) - tongue , somatosensory system , facial muscles , palsy , psychology , genioglossus , functional magnetic resonance imaging , electromyography , medicine , anatomy , audiology , neuroscience , pathology , alternative medicine
A hypoglossal–facial transfer is a common surgical strategy for reanimating the face after persistent total hemifacial palsy. We were interested in how motor recovery is associated with cortical reorganization of lip and tongue representation in the primary sensorimotor cortex after the transfer. Therefore, we used functional magnetic resonance imaging (fMRI) in 13 patients who underwent a hypoglossal–facial transfer after unilateral peripheral facial palsy. To identify primary motor and somatosensory tongue and lip representation sites, we measured repetitive tongue and lip movements during fMRI. Electromyography (EMG) of the perioral muscles during tongue and lip movements and standardized evaluation of lip elevation served as outcome parameters. We found an association of cortical representation sites in the pre‐ and postcentral gyrus (decreased distance of lip and tongue representation) with symmetry of recovered lip movements (lip elevation) and coactivation of the lip during voluntary tongue movements (EMG‐activity of the lip during tongue movements). Overall, our study shows that hypoglossal–facial transfer resulted in an outcome‐dependent cortical reorganization with activation of the cortical tongue area for restituded movement of the lip. Hum Brain Mapp 35:638–645, 2014. © 2012 Wiley‐Periodicals, Inc.