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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Diffusivity signatures characterize trigeminal neuralgia associated with multiple sclerosis.

David Q Chen1, Danielle D DeSouza1, David J Hayes2

  • 1Institute of Medical Science and Department of Surgery, University of Toronto, Toronto, ON, Canada/Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 30, 2015
PubMed
Summary

Neuroimaging reveals distinct microstructural changes in the trigeminal nerve (CN V) for patients with trigeminal neuralgia (TN) and multiple sclerosis-related TN (MS-TN). These findings offer new insights into neuropathic facial pain mechanisms.

Keywords:
Multiple sclerosisbraindiffusion tensor imaginghigh angular resolution diffusion imagingmagnetic resonance imagingmicrostructuralpainstructuraltractographytrigeminal neuralgia

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Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Physics

Background:

  • Trigeminal neuralgia secondary to multiple sclerosis (MS-TN) is a neuropathic facial pain syndrome.
  • The underlying mechanisms linking MS-related demyelination to MS-TN pain are not well understood.
  • Classic trigeminal neuralgia (TN) is typically caused by neurovascular compression of the fifth cranial nerve (CN V).

Purpose of the Study:

  • To investigate and compare diffusion metrics along different segments of the fifth cranial nerve (CN V) in individuals with MS-TN, classic TN, and healthy controls.
  • To identify differential neuroimaging correlates associated with pain in MS-TN and TN.

Main Methods:

  • Acquisition of 3T MRI data including diffusion-weighted, T1, T2, and FLAIR sequences.
  • Utilized multi-tensor tractography to delineate segments of the fifth cranial nerve (CN V): cisternal, root entry zone (REZ), pontine, and peri-lesional.
  • Measured diffusion metrics: fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), and mean diffusivity (MD) for each CN V segment.

Main Results:

  • Distinct diffusivity patterns were observed across CN V segments in the studied groups.
  • Patients with classic TN exhibited higher FA in the cisternal segment and lower FA in the ipsilateral REZ segment.
  • Individuals with MS-TN showed reduced FA in ipsilateral peri-lesional segments, indicating unique microstructural alterations.

Conclusions:

  • The study successfully demonstrated objective, non-invasive neuroimaging differences in fifth cranial nerve (CN V) microstructure between classic TN and MS-TN.
  • These findings represent a significant advancement in the methodologies available for studying neuropathic pain in multiple sclerosis (MS).