Trakya University, Department of Neurosurgery, Edirne, Turkey; Hacettepe University, Department of Anatomy, Ankara, Turkey.
Istanbul Okan University Hospital, Department of Neurosurgery, Istanbul, Turkey.
Clin Neurol Neurosurg. 2024 Aug;243:108394. doi: 10.1016/j.clineuro.2024.108394. Epub 2024 Jun 13.
Advanced neuroimaging strategies may provide new insights into the underlying mechanisms of trigeminal neuralgia (TN). The objective of this study is to measure central pain centers in patients with long-standing trigeminal neuralgia and compare them to those of normal individuals. The findings of this study could improve the understanding of central region changes related to pain and improve the diagnosis and management of chronic trigeminal pain.
We examined radiologic data from 20 patients with trigeminal neuralgia and 28 healthy controls who underwent 3D iso T1-weighted brain MRI at our university hospital between 2018 and 2023. Patients with a minimum pain duration of 5 years were included and compared with healthy controls. Additionally, patients were categorized into groups based on the presence of vascular compression. The pain-related subcortical structures, such as the cingulate cortex and insula, were analyzed volumetrically using volBrain software. The results were evaluated statistically.
Significant differences were observed in the measurement of the posterior insula (p = 0.014) when comparing patients with trigeminal neuralgia and healthy subjects. Additionally, group comparisons based on the presence of vascular compression revealed significant differences in the Middle Cingulate Cortex (0.036) and Posterior Cingulate Cortex (0.031) between groups, which may be related to the etiological factor.
Understanding changes in central regions related to pain can aid in the diagnosis and management of chronic trigeminal pain.
高级神经影像学策略可能为三叉神经痛（TN）的潜在机制提供新的见解。本研究的目的是测量长期三叉神经痛患者的中枢疼痛中心，并将其与正常个体进行比较。这项研究的结果可以提高对与疼痛相关的中枢区域变化的理解，并改善慢性三叉神经痛的诊断和管理。
我们检查了 20 名三叉神经痛患者和 28 名健康对照者的影像学数据，这些患者在 2018 年至 2023 年间在我们的大学医院接受了 3D iso T1 加权脑 MRI 检查。纳入了疼痛持续时间至少 5 年的患者，并与健康对照组进行比较。此外，根据是否存在血管压迫，将患者分为不同的组。使用 volBrain 软件对与疼痛相关的皮质下结构（如扣带回和脑岛）进行容积分析。对结果进行统计学评估。
在比较三叉神经痛患者和健康受试者时，后岛（p=0.014）的测量存在显著差异。此外，基于血管压迫存在的组间比较显示，中扣带皮层（0.036）和后扣带皮层（0.031）之间存在显著差异，这可能与病因因素有关。
了解与疼痛相关的中枢区域的变化有助于诊断和管理慢性三叉神经痛。
