Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2020 Mar 2;98:109821. doi: 10.1016/j.pnpbp.2019.109821. Epub 2019 Nov 19.
In recent decades, a growing number of structural neuroimaging studies of grey matter (GM) in trigeminal neuralgia (TN) have reported inconsistent alterations. We carried out a systematic review and meta-analysis to identify consistent and replicable GM volume abnormalities using effect-size signed differential mapping (ES-SDM). Furthermore, we conducted a meta-regression to explore the potential effects of clinical characteristics on GM volume alterations in patients with TN. A total of 13 studies with 15 datasets, representing 407 TN patients and 376 healthy individuals, were included in the present study. The results revealed that TN patients had GM volume abnormalities mainly in the basal ganglia, including the putamen, nucleus accumbens (NAc), caudate nucleus and amygdala, as well as the cingulate cortex (CC), thalamus, insula and superior temporal gyrus (STG). The meta-regression analysis showed that verbal rating scale (VRS) scores were negatively correlated with decreased GM volume in the left striatum and that illness duration was negatively correlated with decreased GM volume in the left STG and left insula. These results provide a thorough profile of GM volume alterations in TN patients and constitute robust evidence that aberrant GM volumes in the brain regions regulating and moderating sensory-motor and affective processing may play an important role in the pathophysiology of TN.
近几十年来，越来越多的关于原发性三叉神经痛（TN）灰质（GM）的结构神经影像学研究报告了不一致的改变。我们进行了系统的综述和荟萃分析，使用效应大小有符号差异映射（ES-SDM）来确定 GM 体积异常的一致性和可重复性。此外，我们进行了荟萃回归分析，以探讨临床特征对 TN 患者 GM 体积改变的潜在影响。本研究共纳入了 13 项研究的 15 个数据集，代表了 407 名 TN 患者和 376 名健康对照者。结果表明，TN 患者的 GM 体积异常主要集中在基底节，包括壳核、伏隔核、尾状核和杏仁核，以及扣带回皮质、丘脑、脑岛和颞上回。荟萃回归分析显示，言语评定量表（VRS）评分与左侧纹状体 GM 体积减少呈负相关，病程与左侧颞上回和左侧脑岛 GM 体积减少呈负相关。这些结果提供了 TN 患者 GM 体积改变的详细特征，并构成了强有力的证据，表明调节和调节感觉运动和情感处理的大脑区域中异常的 GM 体积可能在 TN 的病理生理学中起重要作用。
