Pashkov Anton, Filimonova Elena, Zaitsev Boris, Martirosyan Azniv, Moysak Galina, Rzaev Jamil
FSBI "Federal Center of Neurosurgery", Nemirovich-Danchenko street, 132/1, 630087, Novosibirsk, Russia.
Department of neurosurgery, Novosibirsk State Medical University, Novosibirsk, Russia.
Neuroradiology. 2025 Apr;67(4):895-908. doi: 10.1007/s00234-024-03508-7. Epub 2024 Dec 7.
To investigate structural alterations in the thalamus in patients with primary trigeminal neuralgia and provide a detailed perspective on thalamic remodeling in response to chronic pain at the level of individual thalamic nuclei. METHODS: We analyzed a sample of 62 patients with primary trigeminal neuralgia who underwent surgical treatment, along with 28 healthy participants. Magnetic resonance imaging (MRI) data were acquired using a 3T system equipped with a 16-channel receiver head coil. Segmentation of the thalamic nuclei was performed using FreeSurfer 7.2.0. We divided the group of patients with trigeminal neuralgia into two subgroups: those with right-sided pain and those with left-sided pain. Each subgroup was compared to a control group by means of one-way ANOVA. Associations between morphometric and clinical variables were assessed with Spearman correlation coefficient.
Our results revealed significant gray matter volume changes in thalamic nuclei among patients with trigeminal neuralgia. Notably, the intralaminar nuclei (centromedian/parafascicular) and nuclei associated with visual and auditory signal processing (lateral and medial geniculate bodies) exhibited significant alterations, contrasting with the ventral group nuclei involved in nociceptive processing. Additionally, we found no substantial volume increase in any of the studied nuclei following successful surgical intervention 6 months later. The volumes of thalamic nuclei were negatively correlated with pain intensity and disease duration.
The results of this study, although preliminary, hold promise for clinical applications as they reveal previously unknown structural alterations in the thalamus that occur in patients with chronic trigeminal neuralgia.
研究原发性三叉神经痛患者丘脑的结构改变，并从单个丘脑核水平详细阐述丘脑对慢性疼痛的重塑情况。方法：我们分析了62例接受手术治疗的原发性三叉神经痛患者以及28名健康参与者的样本。使用配备16通道接收头线圈的3T系统采集磁共振成像（MRI）数据。采用FreeSurfer 7.2.0对丘脑核进行分割。我们将三叉神经痛患者组分为两个亚组：右侧疼痛患者和左侧疼痛患者。通过单因素方差分析将每个亚组与对照组进行比较。用Spearman相关系数评估形态学和临床变量之间的关联。结果：我们的结果显示，三叉神经痛患者丘脑核的灰质体积有显著变化。值得注意的是，板内核（中央中核/束旁核）以及与视觉和听觉信号处理相关的核（外侧和内侧膝状体）表现出显著改变，这与参与伤害性感受处理的腹侧组核形成对比。此外，我们发现6个月后成功进行手术干预后，所研究的任何核团体积均未大幅增加。丘脑核体积与疼痛强度和病程呈负相关。结论：本研究结果虽属初步，但为临床应用带来了希望，因为它们揭示了慢性三叉神经痛患者丘脑中此前未知的结构改变。
