Measurement of the facial nerve thickness and its correlation with freezing phenomenon and hypomimia in Parkinson's disease

SAÇMACI H., ERKOÇ M. F., Akturk T.

CLINICAL NEUROLOGY AND NEUROSURGERY, vol.210, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 210
  • Publication Date: 2021
  • Doi Number: 10.1016/j.clineuro.2021.106960
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE
  • Keywords: Parkinson's disease, facial nerve, CN VII, nerve, freezing, masked face, SUBTHALAMIC NUCLEUS, BRAIN-STEM, GAIT, FACE, IMPAIRMENT, ANATOMY
  • Yozgat Bozok University Affiliated: Yes


Objective: Hypomimia is one of the diagnostic features in Parkinson's disease, and freezing blocks may also occur with the degenerative process. We investigated that the thickness of the cranial facial nerve that innervates facial expressions, and the relationship between bradymimia and freezing phenomena in these patients. Methods: We included 70 patients and healthy participants in this cross-sectional study. Clinical characteristics, modified Hoehn and Yahr (mHY) stages, Unified Parkinson's Disease Rating Scale (UPDRS) scores and Freezing of Gait Questionnaire (FOG-Q) scores of Parkinson's patients were recorded. FOG-Q was scored between 1 and 4 points. The thickness of the facial nerve and its neighborhoods of numerically equal groups were measured radiologically in the internal acoustic channel (IAC) with magnetic resonance imaging of temporal lobe. Right and left facial nerve thicknesses were compared. Results: The right facial nerve thicknesses of the patient and control groups were measured as 0.97 +/- 0.12 mm and 1.20 +/- 0.10 mm at the proximal level and 0.71 (0.69-0.81) mm and 1.21 (1.13-1.24) mm at the distal level, respectively (P < 0.001). Notably, the facial nerve was more atrophied on the right than on the left (P < 0.001). Facial nerve to IAC ratio (%) was significantly lower and cerebrospinal fluid thickness distance (%) measurement was significantly higher (P < 0.001). Also, the FOG-Q and facial nerve to IAC ratio were negatively correlated (P = 0.049, rho = -0.335). Conclusions: Our study provides new information about the facial nerve and its neighborhoods and clinical relationships in individuals with PD. In studies investigating hypomimia and FOG in Parkinson's, neuroimaging of the facial nerve can also be used. These results need to be proven with more comprehensive studies.