Department of Radiology, Jining No. 1 People's Hospital.
Department of Medical Imaging, Jinan Vocational College of Nursing.
J Craniofac Surg. 2021;32(2):632-636. doi: 10.1097/SCS.0000000000007082.
Patients with classic trigeminal neuralgia (CTN) have abnormalities in white matter integrity of the corpus callosum (CC). However, in CTN patients, it is unclear whether the CC substructure region is affected to varying degrees.
A total of 22 patients with CTN and 22 healthy controls (HC) with matching age, gender, and education were selected. All subjects underwent 3.0 T magnetic resonance diffusion tensor imaging and high resolution T1-weighted imaging. The CC was reconstructed by DTI technology, which was divided into three substructure regions: genu, body, and splenium. Group differences in multiple diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD), were compared between CTN patients and HC, and correlations between the white matter change and disease duration and VAS in CTN patients were assessed.
Compared with HC group, CTN patients had extensive damage to the CC white matter. The FA of the genu (P = 0.04) and body (P = 001) parts decreased, while RD (P = 0.003; P = 0.02) and MD (P = 0.002; P = 0.04) increased. In addition, the authors observed that the disease duration and VAS of CTN patients were negatively correlated with FA.
The corpus callosum substructure region has extensive damage in chronic pain, and the selective microstructural integrity damage was particularly manifested by changes in axons and myelin sheath in the genu and body of corpus callosum.
经典三叉神经痛(CTN)患者胼胝体(CC)的白质完整性存在异常。然而,在 CTN 患者中,CC 亚区结构是否存在不同程度的受累尚不清楚。
共纳入 22 例 CTN 患者和 22 例年龄、性别和教育程度相匹配的健康对照者(HC)。所有受试者均行 3.0T 磁共振弥散张量成像和高分辨率 T1 加权成像。应用 DTI 技术重建 CC,将其分为 3 个亚区:膝部、体部和压部。比较 CTN 患者与 HC 之间各向异性分数(FA)、平均弥散系数(MD)、轴向弥散系数(AD)和径向弥散系数(RD)等多个弥散指标的差异,并评估 CTN 患者白质变化与病程和 VAS 的相关性。
与 HC 组相比,CTN 患者 CC 白质广泛受损。膝部(P=0.04)和体部(P=0.001)FA 值降低,而 RD(P=0.003;P=0.02)和 MD(P=0.002;P=0.04)值升高。此外,作者观察到 CTN 患者的病程和 VAS 与 FA 呈负相关。
慢性疼痛时胼胝体亚区结构广泛受损,选择性的微观结构完整性损伤尤其表现为胼胝体膝部和体部的轴突和髓鞘改变。