Altered structure and functional connection in patients with classical trigeminal neuralgia

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Trigeminal neuralgia (TN) is a neuropathic orofacial pain condition.
• Brain structural and functional plasticity in TN remains poorly understood.

Purpose of the Study:

• To investigate brain structure and connectivity changes in patients with classical trigeminal neuralgia using MRI.
• To explore the relationship between these changes and pain duration.

Main Methods:

• Voxel-based morphometry (VBM) to analyze gray matter volume.
• Resting-state functional MRI (rs-fMRI) to assess brain connectivity.
• Inclusion of 62 TN patients (right and left TN).

Main Results:

• Gray matter volume reduction observed in prefrontal cortex, precentral gyrus, thalamus, and other regions.
• Altered functional connectivity noted between frontal regions and within the thalamus.
• Volume and connectivity changes correlated with pain duration in some brain areas.

Conclusions:

• The thalamus plays a crucial role in pain processing and TN development.
• Brain structural changes associated with emotional/cognitive pain modulation occur with TN chronification.
• The left hemisphere may be dominant in processing and modulating TN pain signals.