Abstract
ObjectiveDiffusion spectrum imaging (DSI) was used to quantitatively study the changes in the trigeminal cistern segment in patients with trigeminal neuralgia (TN) and to further explore the value of acquiring DSI data from patients with TN.MethodsTo achieve high-resolution fiber tracking, 60 patients with TN and 35 healthy controls (HCs) were scanned with conventional magnetic resonance imaging (MRI) and DSI. The patients and the members of the control group were compared within and between groups. The correlations between quantitative parameters of DSI and the visual analog scale (VAS), and symptom duration and responsible vessel types were analyzed.ResultsCompared with unaffected side of patients in the TN group, the affected side showed significantly decreased quantitative anisotropy (QA) (p < 0.001), fractional anisotropy (FA) (p = 0.001), and general FA (GFA) (p < 0.001). The unaffected side exhibited significantly decreased QA (p + 0.001), FA (p = 0.001), and GFA (p < 0.001) and significantly increased axial diffusivity (AD) (p = 0.036) compared with the affected side of patients in the TN group and the average values of HCs. There were significantly decreased QA (p = 0.046) and FA (p = 0.008) between the unaffected side of patients and the average values of HCs. GFA can evidently distinguish arteries, veins, and features of unaffected side in TN patients.ConclusionUsing high-resolution fiber tracking technology, DSI can provide quantitative information that can be used to detect the integrity of trigeminal white matter in patients with TN and can improve the understanding of the disease mechanism.
Highlights
Trigeminal neuralgia (TN) is recurrent, unilateral, transient, and electric pain in the trigeminal nerve distribution area
QA, quantitative anisotropy; AD, axial diffusivity; FA, fractional anisotropy; GFA, general FA. p-values were calculated with independent sample t-test
We found that FA, QA, and GFA values of the affected side of TN patients were significantly lower than those of the unaffected side and healthy controls (HCs)
Summary
Trigeminal neuralgia (TN) is recurrent, unilateral, transient, and electric pain in the trigeminal nerve distribution area. The generally accepted theory is neurovascular compression (NVC). This theory suggests that microvascular compression leads to demyelination of trigeminal nerve roots, causing TN. These vessels that compress the trigeminal nerve are called responsible vessels. Microvascular decompression (MVD), a minimally invasive interventional technique, is designed based on this etiological explanation and has been recognized as the most effective method for the treatment of TN [2, 3]. MVD can identify the painful nerve and effectively isolate the responsible vessels that compress the trigeminal nerve root and brainstem to relieve compression and, repair nerve pain under the operating microscope and eliminate the source of trigeminal nerve pain [4]
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