Department of Neurosurgery, First Affiliated Hospital of Sun Yat-Sen University, No 58th, Zhongshan Er Road, Yuexiu District, Guangzhou, 510080, China.
Center of Universal Medical Imaging Diagnostic, No 80th, Zhongshan Er Road, Yuexiu District, Guangzhou, 510080, China.
BMC Neurol. 2022 Oct 12;22(1):384. doi: 10.1186/s12883-022-02906-9.
Neurovascular compression (NVC) produces morphological changes on the trigeminal nerve root is considered the cause of trigeminal neuralgia (TN), but there were some patients with TN found no NVC, and also NVC was found in asymptomatic individuals. Many studies found tight relationships of TN and morphological structures of trigeminal nerve. We designed this study to explore the correlation between multiplanar reconstruction (MPR) trigeminal nerve angulation (TNA) and TN.
Patients with classical symptoms of TN were recruited as observation group (OG) in this study, 50 healthy controls were enrolled as control group (CG), the OG was further subtyped into young patients (YP), middle-aged patients (MP) and old patients (OP) based to the onset age of symptoms, and also divided into patients with or without trigger maneuvers (TM) based on the presence of TM or not. All the participants underwent magnetic resonance (MR) examinations in same device, bilateral TNA measurements were carried out in OG and CG, then TNA was compared between different groups or subgroups. All images were interpreted by two radiologists who were blinded to the study, diagnosis of TN was made by two senior neurosurgery professors.
Ultimately, 95 patients with primary TN were recruited in OG, aged from 25 to 84 (61.15 ± 12.70) years with a course of 0.5 to 30 (5.03 ± 5.41) years, their onset age ranged from 24 to 82 (56.13 ± 11.98) years. There were 34 males and 61 females in OG, and 58 cases involved right side. The CG aged from 22 to 85 (61.86 ± 13.03) years. No statistical difference was found between the age of OG and CG(p = 0.76), and also the bilateral TNA of CG (154.92 ± 16.90° vs 155.55 ± 17.03°, p > 0.05), while TNA of OG was significantly smaller than CG (150.78 ± 11.29° vs 155.24 ± 16.88°, p = 0.019). In OG, TNA on the affected side was significantly smaller than the unaffected side (149.29 ± 12.44° vs 152.27 ± 9.85°, p = 0.014). TNA showed a positive correlation with onset age of patients with TN, as TNA on the affected side of YP was significantly smaller than MP and OP (139.00 ± 11.64° vs 148.86 ± 11.54°, 139.00 ± 11.64° vs 152.18 ± 12.61°, p = 0.004 and 0.026). Furthermore, patients with TM showed smaller TNA than those without TM (147.05 ± 11.30° vs 164.75 ± 8.39°, p < 0.001).
This study suggested that TNA might play a role in TN, small TNA could be a risk factor of TN. Furthermore, patients with small TNA are more likely to combine with TM, but more studies are needed to explore the exact role of TNA in TN.
神经血管压迫（NVC）导致三叉神经根形态改变被认为是三叉神经痛（TN）的原因，但有些 TN 患者没有发现 NVC，也有 NVC 存在于无症状个体中。许多研究发现 TN 与三叉神经形态结构之间存在紧密关系。我们设计了这项研究来探讨多平面重建（MPR）三叉神经角度（TNA）与 TN 之间的相关性。
本研究招募了具有典型 TN 症状的患者作为观察组（OG），50 名健康对照者作为对照组（CG），OG 进一步根据症状发病年龄分为年轻患者（YP）、中年患者（MP）和老年患者（OP），也根据是否存在触发动作（TM）分为有 TM 组和无 TM 组。所有参与者均在同一设备上进行磁共振（MR）检查，对 OG 和 CG 进行双侧 TNA 测量，然后比较不同组或亚组之间的 TNA。所有图像均由两名对研究不知情的放射科医生进行解读，TN 的诊断由两位资深神经外科教授做出。
最终，OG 共纳入 95 例原发性 TN 患者，年龄 25 至 84 岁（61.15±12.70 岁），病程 0.5 至 30 年（5.03±5.41 年），发病年龄 24 至 82 岁（56.13±11.98 岁）。OG 中有 34 名男性和 61 名女性，58 例累及右侧。CG 年龄 22 至 85 岁（61.86±13.03 岁）。OG 与 CG 的年龄无统计学差异（p=0.76），CG 的双侧 TNA 也无统计学差异（154.92±16.90° vs 155.55±17.03°，p>0.05），而 OG 的 TNA 明显小于 CG（150.78±11.29° vs 155.24±16.88°，p=0.019）。在 OG 中，患侧的 TNA 明显小于健侧（149.29±12.44° vs 152.27±9.85°，p=0.014）。TNA 与 TN 患者的发病年龄呈正相关，YP 患者患侧的 TNA 明显小于 MP 和 OP（139.00±11.64° vs 148.86±11.54°，139.00±11.64° vs 152.18±12.61°，p=0.004 和 0.026）。此外，有 TM 的患者 TNA 明显小于无 TM 的患者（147.05±11.30° vs 164.75±8.39°，p<0.001）。
本研究表明 TNA 可能在 TN 中起作用，小 TNA 可能是 TN 的一个危险因素。此外，小 TNA 的患者更有可能合并 TM，但需要更多的研究来探讨 TNA 在 TN 中的确切作用。
