面肌痉挛患者神经血管接触/压迫分级与症状、认知及情绪异常的相关性

目的 探讨面肌痉挛患者面神经出脑干区（REZ）神经血管接触/压迫（NVC）分级与痉挛严重程度、患者认知及情绪的联系。方法 收集21例HFS患者（HFS组）以及性别、年龄匹配的21名正常志愿者（对照组），完成蒙特利尔认知评估量表（MoCA）、汉密尔顿抑郁量表（HAMD）及汉密尔顿焦虑量表（HAMA）后，行三维快速稳态梯度回波序列（3D-FIESTA）和3D-TOF MRA扫描及多方位重建，评价NVC分级；运用Cohen痉挛分级评价患者面肌抽搐分级。结果 HFS组面神经NVC分级：2例未见责任血管（0分），5例轻度（1分），9例中度（2分），5例重度（3分）。HFS患者Cohen痉挛分级结果为2级8例，3级9例，4级4例。HFS组MoCA评分低于对照组（P<0.001），而HAMD及HAMA评分均高于对照组（P<0.001）。REZ区面神经NVC分级与痉挛严重程度及呈线性正相关（r=0.81，P<0.01），NVC分级与MoCA评分呈负相关（r=-0.47，P<0.05），与HAMA评分呈正相关（r=0.47，P<0.05）。结论 NVC分级可能部分反映HFS患者痉挛的严重程度，且与认知障碍和焦虑水平存在一定关系。

Correlation of neurovascular contact/compression grade with severity of spasm, impaired cognition and emotion in patients with hemifacial spasm

Objective To explore the correlation between the grade of neurovascular contact/compression (NVC) in the root exit zone (REZ) of facial nerves and spasm severity, cognition and emotion in patients with hemifacial spasm (HFS). Methods Totally 21 patients with HFS (HFS group) and 21 age-and gender-matched healthy volunteers (control group) were collected and underwent three questionnaires, including Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD) and Hamilton anxiety scale (HAMA) before MR scanning. Three-dimensional fast imaging employing state acquisition (3D-FIESTA) and 3D-TOF MRA sequences were performed. The grade of NVC in each patient was evaluated using scores of 1 to 3 (1 mild, 2 moderate, 3 severe). The severity of spasm was rated according to the spasm severity rating by Cohen. Results In HFS group, offending vessel was not found in 2 cases, NVC ratings of others were mild in 5 cases, moderate in 9 and severe in 5 cases. According to spasm severity rating by Cohen, level 2 was found in 8 cases, while level 3 in 9 and level 4 in 4 cases. There was positive correlation between the spasm severity and the ratings of NVC. In addition, HFS patients had lower MoCA values, higher HAMA and HAMD scores than those of control group (all P<0.001), and positive correlation existed found between spasm severity rating and NVC ratings (r=0.81, P<0.01), as well as between HAMA scores and NVC ratings (r=0.47, P<0.05), while negative correlation existed between MoCA values and NVC ratings (r=-0.47, P<0.05). Conclusion The rating of NVC may be the marker of spasm severity in some degree, which correlates with the severity of cognitive impairment in patients with HFS.