Gray and white matter abnormalities in primary trigeminal neuralgia with and without neurovascular compression

Wu, Min; Jiang, Xiaofeng; Qiu, Jun; Fu, Xianming; Niu, Chaoshi

doi:10.1186/s10194-020-01205-3

Cited by 28 publications

(38 citation statements)

References 45 publications

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“…The present study employed 3D T2-SPACE images to examine cortical/subcortical brain GMVs based on VBM analysis. A previous study reported that patients with TN had greater GMVs in the thalamus, contralateral S1, amygdala, frontal pole, PAG, primary motor cortex, and basal ganglia and cortical thinning in the orbitofrontal cortex, pregenual ACC, and insula [ 29 ], whereas anther study reported that patients with TN showed GMV reductions including the frontal, temporal, and parietal areas, as well as in the left thalamus and right cerebellum [ 30 ]. Our study found that patients with TN had significantly lower GMVs in PCC, ACC, insula, amygdala, and S1 in the affected side compared with the contralateral side before treatment.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal alterations of the cisternal segment of trigeminal nerve and brain pain-matrix regions in patients with trigeminal neuralgia before and after treatment

Chen

et al. 2021

BMC Neurosci

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Background Trigeminal neuralgia (TN) is the most common type of chronic neuropathic facial pain, but the etiology and pathophysiological mechanisms after treatment are still not well understood. The purpose of this study was to investigate the longitudinal changes of the cisternal segment of the trigeminal nerve and brain pain-related regions in patients with TN before and after treatment using readout segmentation of long variable echo-train (RESOLVE) diffusion tensor imaging (DTI) and transverse relaxation (T2)-weighted sampling perfection with application-optimized contrast at different flip angle evolutions (T2-SPACE). Methods Twelve patients with TN and four healthy controls were enrolled in this study. All patients underwent assessment of the visual analog scale (VAS), and acquisition of RESOLVE DTI and T2-SPACE images before and at 1, 6, and 12 months after treatments. Regions-of-interest were placed on the bilateral anterior, middle, and posterior parts of the cisternal segment of the trigeminal nerve, the bilateral root entry zone (REZ), bilateral nuclear zone, and the center of pontocerebellar tracts, respectively. Voxel-based morphometry (VBM) analysis was conducted with T2-SPACE images, and gray matter volumes (GMV) were measured from brain pain-matrix regions. Results The results demonstrated that the VAS scores, the axial diffusivity of the middle part of the affected cisternal trigeminal nerve, the fractional anisotropy of the bilateral nuclear zones, and the mean diffusivity of the center of pontocerebellar tract significantly changed over time before and after treatment. The changes of GMV in the pain-matrix regions exhibited similar trends to the VAS before and after treatment. Conclusion We conclude that magnetic resonance imaging with RESOLVE DTI and VBM with T2-SPACE images were helpful in the understanding of the pathophysiological mechanisms in patients with TN before and after treatment.

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Section: Discussionmentioning

confidence: 99%

Longitudinal alterations of the cisternal segment of trigeminal nerve and brain pain-matrix regions in patients with trigeminal neuralgia before and after treatment

Chen

et al. 2021

BMC Neurosci

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“…The present study employed 3D T2-SPACE images to examine cortical/subcortical brain GMVs based on VBM analysis. A previous study reported that patients with TN had greater GMVs in the thalamus, contralateral S1, amygdala, frontal pole, PAG, primary motor cortex, and basal ganglia and cortical thinning in the orbitofrontal cortex, pregenual ACC, and insula [29], whereas anther study reported that patients with TN showed GMV reductions including the frontal, temporal, and parietal areas, as well as in the left thalamus and right cerebellum [30]. Our study found that patients with TN had signi cantly lower GMVs in PCC, ACC, insula, amygdala, and S1 in the affected side compared with the contralateral side before treatment.…”

Section: Discussionmentioning

confidence: 94%

Longitudinal Alterations of the Cisternal Segment of Trigeminal Nerve and Brain Pain-matrix Regions in Patients with Trigeminal Neuralgia Before and After Treatment

Chen

et al. 2021

Preprint

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Background: Trigeminal neuralgia (TN) is the most common type of chronic neuropathic facial pain, but the etiology and pathophysiological mechanisms after treatment are still not well understood. The purpose of this study was to investigate the longitudinal changes of the cisternal segment of the trigeminal nerve and brain pain-related regions in patients with TN before and after treatment using readout segmentation of long variable echo-train (RESOLVE) diffusion tensor imaging (DTI) and transverse relaxation (T2)-weighted sampling perfection with application-optimized contrast at different flip angle evolutions (T2-SPACE). Methods: Twelve patients with TN and four healthy controls were enrolled in this study. All patients underwent assessment of the visual analog scale (VAS), and acquisition of RESOLVE DTI and T2-SPACE images before and at 1, 6, and 12 months after treatments. Regions-of-interest were placed on the bilateral anterior, middle, and posterior parts of the cisternal segment of the trigeminal nerve, the bilateral root entry zone (REZ), bilateral nuclear zone, and the center of pontocerebellar tracts, respectively. Voxel-based morphometry (VBM) analysis was conducted with T2-SPACE images, and gray matter volumes (GMV) were measured from brain pain-matrix regions. Results: The results demonstrated that the axial diffusivity of the middle part of the cisternal trigeminal nerve, the fractional anisotropy of the bilateral nuclear zones, and the mean diffusivity of the center of pontocerebellar tract significantly changed over time before and after treatment. The changes of GMV in the pain-matrix regions exhibited similar trends to the VAS before and after treatment. Conclusion: We conclude that magnetic resonance imaging with RESOLVE DTI and VBM with T2-SPACE images were helpful in the understanding of the pathophysiological mechanisms in patients with TN before and after treatment.

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“…They observed significantly lower gray matter volume and cortical thickness in TN with NVC than in TN without NVC (Wu et al, 2020). Moreover, they observed extensive alterations in white matter integrity (Wu et al, 2020). DeSouza et al, using diffusion tensor imaging data, also found abnormalities in brain white matter: lower FA, and higher RD, AD, and MD.…”

Section: Brain White and Gray Matter Changesmentioning

confidence: 95%

“…They employed voxel-based and surface-based morphometry to analyze whole-brain gray matter quantitatively. They observed significantly lower gray matter volume and cortical thickness in TN with NVC than in TN without NVC (Wu et al, 2020 ).…”

Section: Brain White and Gray Matter Changesmentioning

confidence: 99%

The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

Szmyd

Sołek

Błaszczyk

et al. 2022

Front. Mol. Neurosci.

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Neurovascular compression syndromes (NVC) are challenging disorders resulting from the compression of cranial nerves at the root entry/exit zone. Clinically, we can distinguish the following NVC conditions: trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. Also, rare cases of geniculate neuralgia and superior laryngeal neuralgia are reported. Other syndromes, e.g., disabling positional vertigo, arterial hypertension in the course of NVC at the CN IX-X REZ and torticollis, have insufficient clinical evidence for microvascular decompression. The exact pathomechanism leading to characteristic NVC-related symptoms remains unclear. Proposed etiologies have limited explanatory scope. Therefore, we have examined the underlying pathomechanisms stated in the medical literature. To achieve our goal, we systematically reviewed original English language papers available in Pubmed and Web of Science databases before 2 October 2021. We obtained 1694 papers after eliminating duplicates. Only 357 original papers potentially pertaining to the pathogenesis of NVC were enrolled in full-text assessment for eligibility. Of these, 63 were included in the final analysis. The systematic review suggests that the anatomical and/or hemodynamical changes described are insufficient to account for NVC-related symptoms by themselves. They must coexist with additional changes such as factors associated with the affected nerve (e.g., demyelination, REZ modeling, vasculature pathology), nucleus hyperexcitability, white and/or gray matter changes in the brain, or disturbances in ion channels. Moreover, the effects of inflammatory background, altered proteome, and biochemical parameters on symptomatic NVC cannot be ignored. Further studies are needed to gain better insight into NVC pathophysiology.

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Gray and white matter abnormalities in primary trigeminal neuralgia with and without neurovascular compression

Cited by 28 publications

References 45 publications

Longitudinal alterations of the cisternal segment of trigeminal nerve and brain pain-matrix regions in patients with trigeminal neuralgia before and after treatment

Longitudinal alterations of the cisternal segment of trigeminal nerve and brain pain-matrix regions in patients with trigeminal neuralgia before and after treatment

Longitudinal Alterations of the Cisternal Segment of Trigeminal Nerve and Brain Pain-matrix Regions in Patients with Trigeminal Neuralgia Before and After Treatment

The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review

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