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Updated: Dec 20, 2025
In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
Published on: February 21, 2018
Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance
Tiffani J Mungoven1, Noemi Meylakh1, Kasia K Marciszewski1
1Department of Anatomy and Histology, F13, University of Sydney, Sydney, NSW, 2006, Australia.
Background:
There is histological evidence of microstructural changes in the zygomaticotemporal branch of the trigeminal nerve in migraineurs. This raises the possibility that altered trigeminal nerve properties contribute to migraine pathophysiology. Whilst it is not possible to explore the anatomy of small trigeminal nerve branches it is possible to explore the anatomy of the trigeminal root entry zone using magnetic resonance imaging in humans. The aim of this investigation is to assess the microstructure of the trigeminal nerve in vivo to determine if nerve alterations occur in individuals with episodic migraine.
Methods:
In 39 migraineurs and 39 matched controls, T1-weighted anatomical images were used to calculate the volume (mm3) and maximal cross-sectional area of the trigeminal nerve root entry zone; diffusion tensor images were used to calculate fractional anisotropy, mean diffusion, axial diffusion and radial diffusion.
Results:
There were significant differences between the left and right nerve of controls and migraineurs with respect to volume and not cross-sectional area. Migraineurs displayed reduced axial diffusion in the right nerve compared to the left nerve, and reduced fractional anisotropy in the left nerve compared to left controls. Furthermore, although there were no differences in mean diffusion or radial diffusion, regional analysis of the nerve revealed significantly greater radial diffusion in the middle and rostral portion of the left trigeminal nerve in migraineurs compared with controls.
Conclusions:
Migraine pathophysiology is associated with microstructural abnormalities within the trigeminal nerve that are consistent with histological evidence of altered myelin and/or organization. These peripheral nerve changes may provide further insight into migraine pathophysiology and enable a greater understanding for targeted treatments of pain alleviation.
Insights
Migraine is linked to microstructural changes in the trigeminal nerve, suggesting nerve abnormalities contribute to migraine pathophysiology. These findings may lead to targeted pain relief treatments.
Area of Science:
- Neurology
- Neuroimaging
- Migraine Research
Background:
- Histological studies show trigeminal nerve microstructural changes in migraineurs.
- Altered trigeminal nerve properties are hypothesized to contribute to migraine pathophysiology.
- Investigating the trigeminal nerve root entry zone using MRI is feasible in humans.
Purpose of the Study:
- To assess trigeminal nerve microstructure in vivo using magnetic resonance imaging (MRI).
- To determine if nerve alterations occur in individuals with episodic migraine.
Main Methods:
- 39 migraineurs and 39 matched controls underwent MRI.
- T1-weighted images calculated trigeminal nerve root entry zone volume and cross-sectional area.
- Diffusion tensor imaging measured fractional anisotropy, mean diffusion, axial diffusion, and radial diffusion.
Main Results:
- Migraineurs showed reduced axial diffusion in the right nerve and reduced fractional anisotropy in the left nerve compared to controls.
- Regional analysis revealed greater radial diffusion in the middle and rostral left trigeminal nerve of migraineurs.
- Significant differences in nerve volume were observed between left and right nerves in both groups, but not in cross-sectional area.
Conclusions:
- Migraine pathophysiology involves trigeminal nerve microstructural abnormalities, suggesting altered myelin and/or organization.
- These peripheral nerve changes offer insights into migraine mechanisms.
- Understanding these changes may facilitate the development of targeted pain alleviation treatments.
