Cognitive Decline in Patients With Trigeminal Neuralgia: A Resting-State fMRI Study.

OBJECTIVE

This study utilized functional magnetic resonance imaging (fMRI) data to investigate cognitive function changes in trigeminal neuralgia (TN) patients and healthy controls (HCs), and to elucidate the potential mechanism.

MATERIALS AND METHODS

The cognitive function of 34 patients with TN and 30 HCs was evaluated. Afterward, we calculated the amplitude of low-frequency fluctuations (ALFFs), regional homogeneity (ReHo), and degree centrality (DC). These metrics were correlated with cognitive performance using the Spearman correlation analysis.

RESULTS

Patients with TN exhibited diminished cognitive performance compared to HCs. Increased mean ALFF (mALFF) levels were detected in the right temporal pole, superior temporal gyrus, and right insula in individuals with TN. These increases were negatively correlated with cognitive function. In contrast, decreased mALFF values were observed in the right lingual gyrus, bilateral calcarine, and left middle occipital gyrus, which were associated with improved cognitive function. Increased DC values were found in various areas, such as the right temporal pole, superior temporal gyrus, right opercular inferior frontal gyrus, bilateral medial superior frontal gyrus, left supplementary motor area, left anterior cingulum, and right middle cingulum in individuals with TN. These values negatively correlated with cognitive performance.

CONCLUSION

TN patients exhibited impairments in multiple cognitive areas, such as attention, memory, executive function, visual perception and executive ability, information processing speed, and motor speed. The metrics ALFF and DC exhibited alterations in TN patients, suggesting that cognitive impairments may be linked to decreased functional activity in specific brain regions. Concurrently, certain cerebral regions may exhibit increased functional activity as a compensatory response to cognitive deficits. These findings hold significant theoretical value and clinical application potential, providing novel methodologies and perspectives for early diagnosis, personalized treatment, and efficacy evaluation. Such advancements are poised to enhance the overall treatment outcomes and quality of life for TN patients.