Gray matter volume reduction with different disease duration in trigeminal neuralgia

Shen, Shanshan; Zheng, Huifeng; Wang, Jianwei; Guo, Wenchang; Guo, Xiaowan; Ji, Hong; Zhang, Shuqian; Chen, Yingmin; Shi, Guo‐Ming

doi:10.1007/s00234-021-02783-y

Cited by 13 publications

(9 citation statements)

References 56 publications

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“…The involvement of brain motor areas observed in patients suffering chronic pain may stem from the fact that they are often forced to restrict their movements and learn to act differently in order not to provoke or exacerbate pain. Consistent with this trend, studies focusing on patients with trigeminal neuralgia have also reported noticeable structural changes occurring in motor-related areas of these individuals [12,36].…”

Section: Discussionsupporting

confidence: 56%

Thalamic nuclei in patients with chronic facial pain: gray matter volume patterns before and after surgery

Anton,

Elena,

Boris

et al. 2023

Preprint

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Trigeminal neuralgia is a prevalent chronic pain disorder characterized by recurring episodes of intense facial pain, which significantly impairs patients’ quality of life. MRI-based biomarkers have consistently demonstrated their ability to predict pain intensity and treatment outcomes. However, most studies have primarily focused on the trigeminal system, disregarding the extensive neural reorganization that occurs throughout the brain in response to chronic pain. In this study, we aimed to examine the thalamus, a key brain structure involved in information processing, and provide a detailed perspective on thalamic remodeling in response to chronic pain at the level of individual thalamic nuclei. We analyzed a sample of 61 patients with primary trigeminal neuralgia undergoing surgical treatment, along with 28 healthy participants. Our results revealed significant gray matter volume changes in thalamic nuclei among patients with trigeminal neuralgia. Notably, the intralaminar nuclei (centromedian/parafascicular) and nuclei associated with visual and auditory signal processing (lateral and medial geniculate bodies) exhibited significant alterations, contrasting with the ventral group nuclei involved in nociceptive processing. Additionally, we found no substantial volume increase in any of the studied nuclei following successful surgical intervention. The volumes of thalamic nuclei were negatively correlated with pain intensity and disease duration, while positively correlated with working memory scores. The findings obtained in this study, albeit preliminary, have promising clinical implications as they unveil previously unknown facets of chronic pain development and provide valuable guidance for clinical decision-making.

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Section: Discussionsupporting

confidence: 56%

Thalamic nuclei in patients with chronic facial pain: gray matter volume patterns before and after surgery

Anton,

Elena,

Boris

et al. 2023

Preprint

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“…The local amyloid deposition in the locus coeruleus and the norepinephrine derangement could explain the initial mild cognitive impairment and the early AD symptoms due to hippocampal diencephalic and para-hippocampal retro splenial network involvement [ 94 ]. A similar process could involve the entorhinal cortex as many studies on trigeminal neuralgia are showing an overall gray matter volume reduction in patients with chronic diseases [ 95 ]. The increasing burden of P. gingivalis and the inflammation and leakage of inflammatory mediators from the established periodontal disease lesions may initiate the latter effects of gingipains in the alteration of BBB permeability [ 53 ].…”

Section: Could the Trigeminal Nerve Pathway Act As The Entrance For ...mentioning

confidence: 96%

The Mechanistic Pathways of Periodontal Pathogens Entering the Brain: The Potential Role of Treponema denticola in Tracing Alzheimer’s Disease Pathology

Pisani

Arcangeli

et al. 2022

IJERPH

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Alzheimer’s Disease (AD) is a complex neurodegenerative disease and remains the most common form of dementia. The pathological features include amyloid (Aβ) accumulation, neurofibrillary tangles (NFTs), neural and synaptic loss, microglial cell activation, and an increased blood–brain barrier permeability. One longstanding hypothesis suggests that a microbial etiology is key to AD initiation. Among the various periodontal microorganisms, Porphyromonas gingivalis has been considered the keystone agent to potentially correlate with AD, due to its influence on systemic inflammation. P. gingivalis together with Treponema denticola and Tannerella forsythia belong to the red complex consortium of bacteria advocated to sustain periodontitis within a local dysbiosis and a host response alteration. Since the implication of P. gingivalis in the pathogenesis of AD, evidence has emerged of T. denticola clusters in some AD brain tissue sections. This narrative review explored the potential mode of spirochetes entry into the AD brain for tracing pathology. Spirochetes are slow-growing bacteria, which can hide within ganglia for many years. It is this feature in combination with the ability of these bacteria to evade the hosts’ immune responses that may account for a long lag phase between infection and plausible AD disease symptoms. As the locus coeruleus has direct connection between the trigeminal nuclei to periodontal free nerve endings and proprioceptors with the central nervous system, it is plausible that they could initiate AD pathology from this anatomical region.

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“…However, we did not observe GMV alterations in basal ganglia and thalamus in patients with CTN, which were caused by the different disease durations of CTN in our study. This is supported by Shen et al’s (2022) study, which used VBM to investigate the changes in brain structure in patients with CTN grouped according to disease duration and they found GMV alterations in different brain regions at different stages of CTN. Tsai et al (2018) found reduced volume in the thalamus, but along with the duration of the disease, the volume of the thalamus gradually increased.…”

Section: Discussionmentioning

confidence: 71%

Structural and Functional Brain Changes in Patients With Classic Trigeminal Neuralgia: A Combination of Voxel-Based Morphometry and Resting-State Functional MRI Study

Líu

Hou

et al. 2022

Front. Neurosci.

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ObjectivesBrain structural and functional abnormalities have been separately reported in patients with classic trigeminal neuralgia (CTN). However, whether and how the functional deficits are related to the structural alterations remains unclear. This study aims to investigate the anatomical and functional deficits in patients with CTN and explore their association.MethodsA total of 34 patients with CTN and 29 healthy controls (HCs) with age- and gender-matched were recruited. All subjects underwent structural and resting-state functional magnetic resonance imaging (fMRI) scanning and neuropsychological assessments. Voxel-based morphometry (VBM) was applied to characterize the alterations of gray matter volume (GMV). The amplitude of low-frequency fluctuation (ALFF) method was used to evaluate regional intrinsic spontaneous neural activity. Further correlation analyses were performed between the structural and functional changes and neuropsychological assessments.ResultsCompared to the HCs, significantly reduced GMV was revealed in the right hippocampus, right fusiform gyrus (FFG), and temporal-parietal regions (the left superior/middle temporal gyrus, left operculo-insular gyrus, left inferior parietal lobule, and right inferior temporal gyrus) in patients with CTN. Increased functional activity measured by zALFF was observed mainly in the limbic system (the bilateral hippocampus and bilateral parahippocampal gyrus), bilateral FFG, basal ganglia system (the bilateral putamen, bilateral caudate, and right pallidum), left thalamus, left cerebellum, midbrain, and pons. Moreover, the right hippocampus and FFG were the overlapped regions with both functional and anatomical deficits. Furthermore, GMV in the right hippocampus was negatively correlated with pain intensity, anxiety, and depression. GMV in the right FFG was negatively correlated with illness duration. The zALFF value in the right FFG was positively correlated with anxiety.ConclusionOur results revealed concurrent structural and functional changes in patients with CTN, indicating that the CTN is a brain disorder with structural and functional abnormalities. Moreover, the overlapping structural and functional changes in the right hippocampus and FFG suggested that anatomical and functional changes might alter dependently in patients with CTN. These findings highlight the vital role of hippocampus and FFG in the pathophysiology of CTN.

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Gray matter volume reduction with different disease duration in trigeminal neuralgia

Cited by 13 publications

References 56 publications

Thalamic nuclei in patients with chronic facial pain: gray matter volume patterns before and after surgery

Thalamic nuclei in patients with chronic facial pain: gray matter volume patterns before and after surgery

The Mechanistic Pathways of Periodontal Pathogens Entering the Brain: The Potential Role of Treponema denticola in Tracing Alzheimer’s Disease Pathology

Structural and Functional Brain Changes in Patients With Classic Trigeminal Neuralgia: A Combination of Voxel-Based Morphometry and Resting-State Functional MRI Study

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