Purpose

Structural magnetic resonance imaging is widely used to explore brain gray and white matter structure in trigeminal neuralgia (TN) but has yielded conflicting findings. This study investigated the relationship between disease duration as a clinical feature of TN and changes in brain structure.

Methods

We divided 49 TN patients into three groups (TN1–TN3) based on disease duration (TN1 = 1.1 ± 0.7 (0–2) years, TN2 = 4.8 ± 1.5 (3–7) years, TN3 = 15.1 ± 5.5 (10–30) years). We used voxel-based morphometry (VBM) to compare the gray matter volume (GMV) across groups and between TN patients and 18 matched healthy control subjects.

Results

The TN1 group showed reduced GMV of pain-related regions in the cerebellum; the TN2 group showed reduced GMV in the thalamus and the motor/sensory cortex; and the TN3 group showed reduced GMV in the emotional and reward circuits compared with healthy controls. Similar brain regions, including bilateral hippocampi, caudate, left insular cortex, and medial superior frontal cortex, were affected in TN2 and TN3 compared with TN1.

Conclusion

Disease duration can explain differences in structural alterations—especially in pain-related brain regions—in TN. These results highlight the advanced structural neuroimaging method that are valuable tools to assess the trigeminal system in TN and may further our current understanding of TN pathology.

中文翻译：

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三叉神经痛不同病程灰质体积减少

目的

结构磁共振成像广泛用于探索三叉神经痛 (TN) 患者的大脑灰质和白质结构，但得出的结果相互矛盾。本研究调查了作为 TN 临床特征的疾病持续时间与大脑结构变化之间的关系。

方法

我们根据疾病持续时间将 49 名 TN 患者分为三组 (TN1–TN3)（TN1 = 1.1 ± 0.7 (0–2) 年，TN2 = 4.8 ± 1.5 (3–7) 年，TN3 = 15.1 ± 5.5 (10– 30年）。我们使用基于体素的形态测量学 (VBM) 来比较各组之间以及 TN 患者和 18 名匹配的健康对照受试者之间的灰质体积 (GMV)。

结果

TN1 组显示小脑疼痛相关区域的 GMV 减少；TN2 组显示丘脑和运动/感觉皮层中的 GMV 减少；与健康对照组相比，TN3 组在情绪和奖赏回路中的 GMV 有所降低。与 TN1 相比，TN2 和 TN3 中相似的大脑区域，包括双侧海马、尾状核、左侧岛叶皮层和内侧上额叶皮层受到影响。

结论

疾病持续时间可以解释 TN 中结构改变的差异，尤其是与疼痛相关的大脑区域。这些结果突出了先进的结构神经影像学方法，这些方法是评估 TN 中三叉神经系统的宝贵工具，并可能进一步加深我们目前对 TN 病理学的理解。