Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China.
Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian 361101, P.R. China.
Mol Med Rep. 2019 Aug;20(2):1707-1715. doi: 10.3892/mmr.2019.10404. Epub 2019 Jun 20.
Recent studies have reported structural and functional abnormalities in multiple brain regions of classical trigeminal neuralgia (CTN) patients. Differences in spontaneous neuronal activity between CTN patients and healthy subjects, however, remain unknown. The aim of the present study was to investigate alterations in brain activity by application of amplitude of low frequency fluctuation (ALFF), thus analyzing the correlation between durations of spontaneous pain intensity and ALFF values in CTN patients. A total of 28 CTN patients (male, n=12; female, n=16) and 28 healthy controls (HCs; male, n=12; female, n=16) matched for age and sex were enrolled. All subjects underwent resting‑state functional magnetic resonance imaging and changes in spontaneous brain activity were investigated using an ALFF method. Receiver operating characteristic (ROC) curve analysis was applied to differentiate ALFF values of CTN patients from HCs. Altered ALFF values and clinical manifestations were evaluated using Pearson's correlation analysis. ALFF values of the bilateral inferior cerebellum, bilateral fusiform gyrus, right precentral gyrus, left inferior temporal gyrus, right superior cerebellum, left inferior occipital gyrus and right superior occipital gyrus were significantly higher in CTN patients when compared to HCs. ROC curve analysis of each brain revealed a near‑perfect AUC accuracy. Pearson's correlation analysis revealed the visual analog scale of the right eye to be positively correlated with both left inferior temporal and occipital gyral findings, while episode duration likewise was positively associated with left inferior temporal gyral findings. CTN patients exhibited abnormal spontaneous activity in multiple brain regions closely related to pain regulation and perception, while VAS and CTN episode duration were positively correlated with ALFF signal values in some brain regions. The present findings provide further insight into the pathological mechanisms underlying CTN.
近期研究报道称,经典三叉神经痛(CTN)患者的多个脑区存在结构和功能异常。然而,CTN 患者与健康受试者之间自发神经元活动的差异尚不清楚。本研究旨在通过应用低频振幅(ALFF)分析脑活动的改变,从而分析 CTN 患者自发疼痛强度持续时间与 ALFF 值之间的相关性。共纳入 28 例 CTN 患者(男 12 例,女 16 例)和 28 例年龄和性别相匹配的健康对照者(男 12 例,女 16 例)。所有受试者均接受静息态功能磁共振成像检查,并采用 ALFF 方法分析自发性脑活动的变化。应用受试者工作特征(ROC)曲线分析区分 CTN 患者和 HC 的 ALFF 值。采用 Pearson 相关分析评估改变的 ALFF 值与临床表现之间的相关性。与 HC 相比,CTN 患者双侧小脑下脚、双侧梭状回、右侧中央前回、左侧颞下回、右侧小脑上脚、左侧枕下回和右侧顶枕回的 ALFF 值显著升高。对每个脑区的 ROC 曲线分析显示 AUC 准确率接近完美。Pearson 相关分析显示,右眼视觉模拟评分与左侧颞叶和枕叶发现均呈正相关,而发作持续时间也与左侧颞叶发现呈正相关。CTN 患者多个与疼痛调节和感知密切相关的脑区存在异常自发活动,而 VAS 和 CTN 发作持续时间与一些脑区的 ALFF 信号值呈正相关。这些发现为 CTN 的病理机制提供了进一步的认识。