MRI Texture Analysis Reveals Brain Abnormalities in Medically Refractory Trigeminal Neuralgia

Area of Science:

• Neuroimaging
• Radiology
• Neurology

Background:

• Trigeminal neuralgia (TN) studies often focus on nerve alterations, overlooking brain structural changes.
• Brain changes in TN may influence its development and treatment response, similar to other chronic pain conditions.

Purpose of the Study:

• To identify structural brain differences in classical trigeminal neuralgia (TN) patients versus healthy subjects using texture analysis.
• To investigate the relationship between identified brain abnormalities and clinical features of TN.

Main Methods:

• Prospective recruitment of 14 TN patients and 20 healthy controls.
• Acquisition of 3-Tesla T1-weighted MRI scans.
• Application of texture analysis (autocorrelation, contrast, energy) in predefined brain regions (anterior cingulate, insula, thalamus, brainstem) with voxel-wise and receiver-operator characteristic (ROC) curve analyses.

Main Results:

• Texture analysis identified significant differences in brainstem, insula, and anterior cingulate regions between TN patients and controls.
• Brainstem autocorrelation, anterior insula contrast, and anterior cingulate energy effectively differentiated TN patients from healthy subjects (AUCs 0.84-0.92).
• Anterior insula contrast showed an inverse correlation with TN duration (Spearman r = -0.73).

Conclusions:

• Texture analysis is a valuable tool for detecting structural brain abnormalities in trigeminal neuralgia (TN).
• Identified brain alterations are linked to clinical aspects of TN, such as illness duration.
• These findings highlight the role of structural brain changes in the pathophysiology of TN.