Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shandong Institute of Brain Science and Brain-inspired Research, Jinan, Shandong, China; Department of Neurosurgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong, China.
Clin Neurol Neurosurg. 2023 May;228:107710. doi: 10.1016/j.clineuro.2023.107710. Epub 2023 Apr 7.
Idiopathic trigeminal neuralgia (ITN) is one of the most common types of neuropathic pain, severely affecting the physiological and psychological wellbeing of patients. Recently, fMRI has been used to examine abnormal activation of brain regions in patients with ITN. However, sample sizes have been small in these few studies, and the abnormally activated brain regions remain unclear. Therefore, in the present study, we retrieved and analyzed literature on the brain areas with abnormal or reduced activation in ITN patients, with the aim of providing insight into the neuropathological basis of the disease and to provide new targets for treatment.
We retrieved resting state fMRI studies on trigeminal neuralgia patients from PubMed, the Web of Science and Scopus databases until November 2022, and we extracted the coordinates of the sites with increased or decreased activation. We used activation likelihood estimation (ALE) meta-analysis to identify regions of abnormal activation in ITN patients.
ALE meta-analysis revealed that the left caudate nucleus and right anterior ventral nucleus of the thalamus are abnormally hyperactivated in ITN patients. Moreover, ITN patients showed reduced activation in the left precuneus, middle temporal gyrus, lingual gyrus, and medial frontal gyrus.
ALE meta-analysis identified several brain regions with abnormally high or decreased activation in ITN patients. Sites with altered activation may be potential targets for non-invasive brain stimulation as adjunct therapy for ITN.
特发性三叉神经痛（ITN）是最常见的神经病理性疼痛类型之一，严重影响患者的生理和心理健康。最近，fMRI 已被用于研究 ITN 患者大脑区域的异常激活。然而，这些研究的样本量都很小，异常激活的大脑区域仍不清楚。因此，本研究检索并分析了 ITN 患者大脑区域异常或低激活的文献，旨在为该疾病的神经病理学基础提供见解，并为治疗提供新的靶点。
我们从 PubMed、Web of Science 和 Scopus 数据库中检索了截至 2022 年 11 月三叉神经痛患者的静息态 fMRI 研究，并提取了激活增加或减少的部位的坐标。我们使用激活似然估计（ALE）荟萃分析来确定 ITN 患者异常激活的区域。
ALE 荟萃分析显示，ITN 患者的左侧尾状核和右侧丘脑前腹核异常高激活。此外，ITN 患者的左侧楔前叶、颞中回、舌回和内侧额回的激活减少。
ALE 荟萃分析确定了 ITN 患者大脑中几个异常高或低激活的区域。改变的激活部位可能是作为 ITN 辅助治疗的非侵入性脑刺激的潜在靶点。
