Research On Brain Structure And Resting Functional Connections In Trigeminal Neuralgia Based On Magnetic Resonance Imaging

Objective: Trigeminal neuralgia(TN)is a chronic painful disorder of the face.An increasing number of studies have shown that the central nervous system plays an important role in the development and progression of this disorder.This study aimed to explore the changes in brain structure and function of TN features,including cortical morphological features,gray matter volume(GMV)and functional connectivity(FC)changes.Methods: A total of 56 TN patients and 56 matched healthy controls(HC)underwent three-dimensional T1-weighted magnetic resonance imaging and resting-state functional magnetic resonance imaging(rs-f MRI)in this study.General information was collected for both groups,and scale assessments included the numerical Rating Scale for Pain(NRS),the short form of the Mc Gill Pain Questionnaire(SF-MPQ),the hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD).Cortical thickness,sulcus depth,gyrus index,GMV and FC differences between groups were compared.Correlation analysis was performed between all measurements and clinical data.Results: Compared with HC,TN patients have a thinner thickness of the parahippocampal gyrus,a decrease in the depth of the sulcus of the superior and subparietal lobules,and a decrease in the gyrus index of the anterior and wedge lobes.The course of disease in patients with TN is inversely correlated with the thickness of the cortex of the parietal lobule.Compared with HC,patients with TN have reduced GMV in the right dorsolateral superior frontal gyrus,left prefrontal lobe,left orbital superior frontal gyrus,and right cerebellum.The thalamic hemisphere asymmetry is increased in TN patients and the right amygdala volume is reduced in TN patients.Compared with HC,TN patients have increased FC in the right cerebellum and left supplementary motor area(SMA),and decreased FC in the left prefrontal lobe and left middle frontal gyrus.In TN patients,right supraorbital frontal GMV was positively correlated with total SF-MPQ score(r=0.36,P=0.03),and left prefrontal and left middle frontal gyrus FC were negatively correlated with HAMA score(r=-0.33,P=0.13).Conclusion: The present study observed that structural brain changes in TN patients occurred in brain regions related to pain perception and emotion,and the disease duration had a cumulative effect on cortical thickness.This study further highlights the asymmetric alterations in the thalamus hemisphere in TN patients,which may be a TN-specific early structural change.Using structural abnormalities of the brain as seed points,we found altered FC in TN patients.Using the abnormal brain structure as a seed point,we identified altered FC.Brain structure and function may play an important role in the pathophysiological mechanisms of TN,which helps us to better study TN and ultimately facilitate early intervention for treatment.