Wang Yiwen, Wang Danni, Wu Yingwei, Zhu Ce, Wei Wenbin, Li Yao, Li Lingzhi, Chen Wantao, Chen Minjie
Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
Front Neuroanat. 2023 Mar 22;17:1112662. doi: 10.3389/fnana.2023.1112662. eCollection 2023.
Primary Trigeminal Neuralgia (PTN) is a common and refractory neurological disease. Conventional vascular compression theory could not completely explain the etiology and pathogenesis of PTN. This study used diffusion tensor imaging (DTI) to demonstrate the microstructural changes of root entry zone (REZ) region in PTN patients.
DTI sequences was performed on PTN patients and healthy controls (HCs). Clinical data included affected side, disease course and visual analogue scale (VAS) were collected. Quantitative DTI variables such as FA, MD, AD and RD of the root entry/Exit zone (REZ) were measured and compared in PTN/HCs, affected/unaffected side, and pre/post operation groups. The PCoA was established to conduct overall differences between PTN group and the HCs.
A total of 17 patients with PTN (mean age 59.29 ± 8.53; 5 men) and 34 HCs (mean age 57.70 ± 6.37; 10 men) were included. Lower FA value of the affected side of PTN group was observed compared to the unaffected side and the HCs ( = 0.001), whereas the values of MD, AD and RD were significantly increased ( < 0.001). Moreover, the decrease of FA value was recovered post operation. PCoA results of the comprehensive indexes can significantly distinguish PTN group from HCs ( = 0.500, < 0.001).
Quantitative variables derived from DTI in REZ had significantly different profiles between PTN patients and HCs, which were associated with VAS situation and the disease course of PTN. The comprehensive index established on DTI variables were of great potential to reveal the microstructure changes in PTN patients and predict the therapeutic effect.
原发性三叉神经痛（PTN）是一种常见的难治性神经系统疾病。传统的血管压迫理论无法完全解释PTN的病因和发病机制。本研究采用弥散张量成像（DTI）来显示PTN患者神经根入区（REZ）区域的微观结构变化。
对PTN患者和健康对照者（HCs）进行DTI序列检查。收集临床资料，包括患侧、病程和视觉模拟评分（VAS）。测量并比较PTN/HCs、患侧/未患侧以及术前/术后组中神经根入/出区（REZ）的定量DTI变量，如FA、MD、AD和RD。建立主成分分析（PCoA）以比较PTN组和HCs之间的总体差异。
共纳入17例PTN患者（平均年龄59.29±8.53岁；男性5例）和34例HCs（平均年龄57.70±6.37岁；男性10例）。与未患侧和HCs相比，PTN组患侧的FA值较低（ = 0.001），而MD、AD和RD值显著升高（ < 0.001）。此外，术后FA值的降低得到恢复。综合指标的PCoA结果能够显著区分PTN组和HCs（ = 0.500， < 0.001）。
REZ区域DTI得出的定量变量在PTN患者和HCs之间具有显著不同的特征，这与PTN的VAS情况和病程相关。基于DTI变量建立的综合指标在揭示PTN患者微观结构变化和预测治疗效果方面具有很大潜力。
