Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve

Javier Buendia, Francis R. Loayza, Elkin O. Luis, Marta Celorrio, Maria A. Pastor, Bernardo Hontanilla

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is used to restore the smile, some controversy appears because of the nonphysiological mechanism of smile recovering. Different authors have reported natural results with the masseter nerve. The physiological pathways which determine whether this is achieved continue to remain unclear. Using functional magnetic resonance imaging, brain activation pattern measuring blood-oxygen-level-dependent (BOLD) signal during smiling and jaw clenching was recorded in a group of 24 healthy subjects (11 females). Effective connectivity of premotor regions was also compared in both tasks. The brain activation pattern was similar for smile and jaw-clenching tasks. Smile activations showed topographic overlap though more extended for smile than clenching. Gender comparisons during facial movements, according to kinematics and BOLD signal, did not reveal significant differences. Effective connectivity results of psychophysiological interaction (PPI) from the same seeds located in bilateral facial premotor regions showed significant task and gender differences (p < 0.001). The hypothesis of brain plasticity between the facial nerve and masseter nerve areas is supported by the broad cortical overlap in the representation of facial and masseter muscles.

Original languageEnglish
Pages (from-to)417-426
Number of pages10
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number3
StatePublished - Mar 1 2016


  • BOLD
  • Cortical representation
  • Facial
  • Facial palsy
  • Functional magnetic resonance imaging
  • Masseter


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