Neuroanatomical Determinants of Secondary Trigeminal Neuralgia: Application of 7T Ultra-High-Field Multimodal Magnetic Resonance Imaging

Arrighi‐Allisan, Annie E.; Delman, Bradley N.; Rutland, John W; Yao, Amy; Alper, Judy; Huang, Kuang-Han; Balchandani, Priti; Shrivastava, Raj

doi:10.1016/j.wneu.2019.11.130

Cited by 7 publications

(3 citation statements)

References 30 publications

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“…Diffusion tensor imaging, a technique based on the principle of diffusion motion of water protons in nerve tissue, has recently received attention in TN studies. Several studies support the use of DTI in TN for its ability to expose the CNV at a microstructure level 8 , 15 , 19 , 31 – 37 . DTI has been used to evaluate the efficacy of MVD and gamma knife radiosurgery (GKRS) with the REZ for TN as the therapeutic target 12 , 20 , 22 .…”

Section: Discussionmentioning

confidence: 92%

“…It was important to try and analyze whether FA values on every segment of the CNV could portend recurrence shortly after radiofrequency treatment. TN is characterized not only by diffusion abnormalities on the CNV when compared to controls, but also by abnormalities between the affected and unaffected sides of the TG 18 , 31 , 39 . By combining diffusivity metrics of the bilateral CNVs, the current study results suggest the following findings may herald effective PSR treatment: normal FA value of the unaffected side of the CNV (4/4, 100%); an FA value < 0.30 in the affected side of the TG (9/10, 90%); and a normal FA value of the affected side REZ (6/7, 86%).…”

Section: Discussionmentioning

confidence: 99%

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A novel indicator to predict the outcome of percutaneous stereotactic radiofrequency rhizotomy for trigeminal neuralgia patients: diffusivity metrics of MR-DTI

Su,

Wang,

Wang

et al. 2024

Sci Rep

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Magnetic resonance-diffusion tensor imaging (MR-DTI) has been used in the microvascular decompression and gamma knife radiosurgery in trigeminal neuralgia (TN) patients; however, use of percutaneous stereotactic radiofrequency rhizotomy (PSR) to target an abnormal trigeminal ganglion (ab-TG) is unreported. Fractional anisotropy (FA), mean and radial diffusivity (MD and RD, respectively), and axial diffusivity (AD) of the trigeminal nerve (CNV) were measured in 20 TN patients and 40 healthy control participants immediately post PSR, at 6-months, and at 1 year. Longitudinal alteration of the diffusivity metrics and any correlation with treatment effects, or prognoses, were analyzed. In the TN group, either low FA (value < 0.30) or a decreased range compared to the adjacent FA (dFA) > 17% defined an ab-TG. Two-to-three days post PSR, all 15 patients reported decreased pain scores with increased FA at the ab-TG (P < 0.001), but decreased MD and RD (P < 0.01 each). Treatment remained effective in 10 of 14 patients (71.4%) and 8 of 12 patients (66.7%) at the 6-month and 1-year follow-ups, respectively. In patients with ab-TGs, there was a significant difference in treatment outcomes between patients with low FA values (9 of 10; 90%) and patients with dFA (2 of 5; 40%) (P < 0.05). MR-DTI with diffusivity metrics correlated microstructural CNV abnormalities with PSR outcomes. Of all the diffusivity metrics, FA could be considered a novel objective quantitative indicator of treatment effects and a potential indicator of PSR effectiveness in TN patients.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A novel indicator to predict the outcome of percutaneous stereotactic radiofrequency rhizotomy for trigeminal neuralgia patients: diffusivity metrics of MR-DTI

Su,

Wang,

Wang

et al. 2024

Sci Rep

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“…Likewise, inflammation and trauma can lead to TN. Minute tumor-adjacent vasculature thought to contribute to clinically-symptomatic TN, not seen on conventional low-field imaging, has been identified by seven-tesla ultra-high-field multimodal magnetic resonance imaging using co-registering time-of-flight angiography and T2-weighted turbo-spin echo images [ 30 ]. TN can also be caused by solitary pontine lesions [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Gerwin

2020

IJERPH

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Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15–20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.

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Recent Advances and Future Perspective in MRI Technique for the Trigeminal Neuralgia

Choi

Kang

2023

Trigeminal Neuralgia

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Neuroanatomical Determinants of Secondary Trigeminal Neuralgia: Application of 7T Ultra-High-Field Multimodal Magnetic Resonance Imaging

Cited by 7 publications

References 30 publications

A novel indicator to predict the outcome of percutaneous stereotactic radiofrequency rhizotomy for trigeminal neuralgia patients: diffusivity metrics of MR-DTI

A novel indicator to predict the outcome of percutaneous stereotactic radiofrequency rhizotomy for trigeminal neuralgia patients: diffusivity metrics of MR-DTI

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Recent Advances and Future Perspective in MRI Technique for the Trigeminal Neuralgia

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