Brain Function Changes In Resting FMRI Before And After CT-Guided Radiofrequency Thermocoagulation In Patients With Primary Trigeminal Neuralgia

Objective Functional magnetic resonance imaging(f MRI)technology based on ratio low frequency oscillation amplitude(f-ALFF)was used to observe the brain function status of patients with primary trigeminal neuralgia(ITN)at rest.CT-guided percutaneous radiofrequency thermocoagulation(PRT)treatment of trigeminal ganglia was performed in ITN patients.Then we observed brain function changes of patients with ITN before and after treatment.This will provide a certain reference value for the postoperative prognosis.Methods Twenty ITN patients and 19 age-and sex-matched healthy people were selected as observation objects,and f MRI brain function data were collected by 3.0 T MRI.Later.17 patients with ITN underwent CT-guided trigeminal ganglion pulse radiofrequency thermocoagulation(PRT)treatment,and the same method was used to collect data again three month after surgery.After DPARSF software image processing and calculation of whole brain f-ALFF values.SPSS16.0 and SPM12 software were used to compare ITN patients with healthy people and postoperative patients by t test,chi-square test and Pearson correlation analysis method.We explored the changes in global brain f-ALFF values and pain(VAS score),and the correlation between relevant brain areas and clinical indicators.Results 1.The encephalic regions which the f-ALFF value in ITN patients was higher than that of in healthy people(uncorrected,P < 0.005)are: left putamen,left insular cortex,left frontal orbital cortex,cingulate gyrus,anterior division and rigth middle temporal gyrus.And the f-ALFF value in ITN patients was lower than that of in the healthy people(uncorrected,P < 0.005)are: left frontal pole,cingulate gyrus,posterior division,precuneous cortex and right cerebelum.2.Brain regions with positive correlation between f-ALFF values and VAS scores in ITN patients(uncorrected,P <0.005)is rigth cerebelum.And the regions with negative correlation between f-ALFF values and VAS scores in ITN patients(uncorrected,P < 0.005)are: right occipital cortex,superior division,precuneous cortex,left frontal orbital cortex,left frontal cortex,superior division,left insular cortex,rigtht middle temporal gyrus and left cerebelum.Compared with pre-treatment,the VAS score was reduced(P < 0.05),and no significant adverse reactions occurred after surgery.At the same time,the encephalic regions which the f-ALFF value in postoperative patients was higher than that of in preoperative people(uncorrected,P < 0.005)are: right paracingulate gyrus,right superior frontal gyrus and frontal pole.And the 'f-ALFF value in postoperative patients was lower than that of in preoperative people' f-ALFF value(uncorrected,P < 0.005)are: left postcentral gyrus,left supramarginal gyrus and right middle temporal gyrus.No significant correlation was found between f-ALFF changes in relevant brain areas and postoperative VAS changes and postoperative numbness.Conclusion Compared with the normal population,ITN patients had differences in putamen,insular cortex,frontal orbital cortex,cingulate gyrus,anterior division,medial temporal gyrus,frontal pole,cingulate gyrus,posterior division,precuneous cortex and cerebelum.In ITN patients,f-ALFF values in cerebellum,occipital cortex,superior division,precuneous cortex,frontal orbital cortex,frontal cortex,superior division,insular cortex,middle temporal gyrus are correlated with VAS scores.This suggests that the relevant brain regions are related to the occurrence and development of pain.CT-guided PRT for patients with ITN can relieve pain.And it is safe and reliable.At the same time,there are differences in f-ALFF values before and after operation in paracingulate gyrus,superior frontal gyrus,frontal pole,postcentral gyrus,supramarginal gyrus,middle temporal gyrus.No significant correlation was found between the f-ALFF changes in these brain areas and the postoperative VAS score changes and postoperative numbness.