| Objective To observe the abnormalities of gray matter volume in patients with idiopathic trigeminal neuralgia (ITN) using voxel-based morphometry (VBM). we counted the statistically significant brain area which was compared with control group, did a correlation analysis on general data, aimed at to investigate the relationship between the ITN with GMV changes in the brain, and laid the foundation to explore the ITN central pathogenesis. Materials and Methods 43 cases of ITN which were examined in the Medical Imaging Department of the First Affiliated Hospital of Kunming Medical University were collected from February 2012 to March 2014 as experimental group. All of the cases were nerve vessel compression in the 3D-TOF-MRA and FIESTA sequence scan. In ITN group,21 patients with left idiopathic trigeminal neuralgia were as the LITN group, and 22 patients with right idiopathic trigeminal neuralgia were as RITN group. There were 25 healthy persons as the control group, and they all have no clinical symptoms associated with ITN. Using PHILIPS Achieves 3.0T MR scanner, all of the the ITN patients and healthy volunteers performed T1W-3D-TFE-ref examination. The statistical analysis was performed by SPSS 17.0 statistical software. Firstly, all of the general data was approach to normality testing using the Shapiro-Wilk. Results showed that the age accord with normal distribution in both the experimental group and the control group, but the gender and the education of information didn’t conform to the normal distribution in the three groups. The pain feeling score, pain emotion score, the total pain score, PPI, VSA, and the the druation of pain time didn’t conform to the normal distribution in the exprimental group. So, the normal distribution measurement data was showed by mean ± standard deviation (x±s). The abnormal distribution measurement data was showed by median±quartile range (M±Q). The age was compared by using completely random design analysis of variance between in the three groups. The age and the education of information was compared by using Kruskal-Wallis H between in the three groups. The pain feeling score, pain emotion score, the total pain score, PPI, VSA, and the the druation of pain time was compared by using the Mann-Whitney U testing. When P<0.05, there is statistical significance. The radiologists evaluated the quality of the original image, and removed the image which was influenced by the head motion artifact. Then, we converted the original DICOM format image date to HDR format data by the rest DICOM Sorter software. We preprocessed the structure of T1 by using VBM8 (http://dbm.neuro.uni-jena.de/vbm/) tool box of the SPM8 (Statistical Parametric Mapping, http://www.fil.ion.ucl.ac.uk/spm/) package in Matalab R2009a platform. Finally, we carried out a statistical analysis on the result of the gray matter. Using SPM8 for data analysis, the two independent samples T-test was adopted to compare ITN group with control group. The data of LITN group and RITN group was analysised in the same way. When p<0.001, extent threshold:0, we treated the area which was a continuous set of voxel over 20 as a statistical significance brain area. When p<0.001, extent threshold:FWEc, we counted the area which was different voxel as the statistically significant cerebellum area. we counted the statistically significant brain area which was compared with control group, then did a Pearson correlation analysis on age, and did a Spearson correlation analysis on the education of information, the pain feeling score, pain emotion score, the total pain score, PPI, VSA, and the the druation of pain time respectively in the experimental group. Results:1. The age, gender, and the education of information had no statistically significant difference in both the experimental group and the control group (P>0.05). And the pain feeling score, pain emotion score, the total pain score, PPI, VSA, and the the druation of pain time was no statistically significant difference between the LITN and RITN group.2. Compared with control group, gray matter volume in the right thalamus and both sides cerebellum increased, and gray matter volume in the left cingulate gyrus and the left precuneus reduced in LITN group. Compared with control group, gray matter volume in the both sides cerebellum, the periaqueductal gray matter (PAG), the parahippocampal gyrus (PHG), the left insula and the right cuneus increased, and gray matter volume in the left middle temporal gyrus, the left postcentral gyrus and the right inferior temporal gyrus reduced in RITN group. Compared with LITN group, gray matter volume in the left cerebellum, the both sides insula, the left cingulate gyrus, the right postcentral gyrus increased, and gray matter volume in the right inferior temporal gyrus and the right thalamus reduced in the RITN group (p<0.001, extent thresholdr0).3. Compared with control group, gray matter volume in the left cerebellar lobe ⅧA and ⅧB increased in LITN group. Compared with control group, gray matter volume in the both sides cerebellar lobe Ⅷ A, the vermis Ⅸ, the right cerebellar lobe Ⅵ, and the right cerebellar cms Ⅰ (Cr I) increased in RITN group. Compared with LITN group, there were no statistically significant brain area in the RITN group (p<0.001, extent threshold:FWEc). The GMV increased in the right thalamus was positive related with pain feeling score and pain total score in LITN group. The GMV decreased in the left cingulate gyms was positive related with the pain total score in LITN group. The GMV increased in the PAG, the right cuneus, the right lobular Ⅵ cerebellar hemisphere and the right Cr Ⅰ was negatively related with pain feeling score and pain total score in the RITN group. The GMV increased in the PHG was negatively related with pain total score in the RITN group. Conclusion:Compared with the control group, there were abnormal gray matter volume in patients with ITN. Compared with the control group, the area of the brain with GMV changed was not exactly the same. GMV changed in the cerebellum was related with ITN, the cerebellum could play an important role in the process and development of ITN. |
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