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Related Experiment Video

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Correlations between the trigeminal nerve microstructural changes and the trigeminal-pontine angle features.

Huize Pang1, Hao Sun2, Guoguang Fan3

  • 1Department of Radiology, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.

Acta Neurochirurgica
|November 8, 2019
PubMed
Summary

A smaller trigeminal-pontine angle, indicative of neurovascular compression (NVC), correlates with trigeminal nerve degeneration in primary trigeminal neuralgia (PTN) patients. This angle may be a key factor in PTN development.

Keywords:
3D-FIESTADTIPrimary trigeminal neuralgiaTrigeminal-pontine angle

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Neurovascular compression (NVC) is linked to trigeminal nerve changes in primary trigeminal neuralgia (PTN).
  • Understanding the trigeminal-pontine angle's role in nerve microstructural changes is crucial.

Purpose of the Study:

  • To investigate the relationship between the trigeminal-pontine angle and trigeminal nerve microstructural integrity.
  • To assess diffusion tensor imaging (DTI) metrics in relation to NVC in PTN.

Main Methods:

  • High-resolution 3D MRI and DTI were used in 25 PTN patients undergoing microvascular decompression (MVD) and 25 controls.
  • Evaluated trigeminal-pontine angle, cerebellopontine angle (CPA) cistern area, and trigeminal nerve length.
  • Measured fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the NVC site and performed correlation analyses.

Main Results:

  • The trigeminal-pontine angle and FA were significantly smaller, while ADC was significantly increased on the affected side in PTN patients compared to controls.
  • A sharper angle was observed when the superior cerebellar artery (SCA) caused compression.
  • No significant differences in CPA cistern area or trigeminal nerve length were found.

Conclusions:

  • A sharp trigeminal-pontine angle may predispose to NVC and nerve degeneration.
  • This angle could be a contributing factor in the pathogenesis of trigeminal neuralgia.
  • DTI metrics like FA and ADC reflect nerve damage associated with NVC.