Correlation study between multiplanar reconstruction trigeminal nerve angulation and trigeminal neuralgia

Area of Science:

• Neurosurgery
• Radiology
• Neurology

Background:

• Trigeminal neuralgia (TN) is often attributed to neurovascular compression (NVC), but its absence in some TN patients and presence in asymptomatic individuals suggests other factors are involved.
• Morphological changes of the trigeminal nerve have been consistently linked to TN.
• Trigeminal nerve angulation (TNA) is a measurable morphological parameter that may correlate with TN.

Purpose of the Study:

• To investigate the correlation between multiplanar reconstruction (MPR) trigeminal nerve angulation (TNA) and trigeminal neuralgia (TN).
• To determine if TNA is a risk factor for TN and if it is associated with specific patient subgroups or clinical features.

Main Methods:

• 95 primary TN patients (observation group) and 50 healthy controls (control group) underwent magnetic resonance (MR) imaging on the same device.
• Bilateral TNA measurements were performed, and TNA was compared between TN patients and controls, as well as within TN subgroups (age, presence of trigger maneuvers).
• TN diagnosis was confirmed by senior neurosurgery professors, and image interpretation was done by blinded radiologists.

Main Results:

• TNA was significantly smaller in TN patients compared to controls (150.78° vs 155.24°, p=0.019).
• In TN patients, TNA on the affected side was smaller than on the unaffected side (149.29° vs 152.27°, p=0.014).
• Younger TN patients and those with trigger maneuvers exhibited significantly smaller TNA.

Conclusions:

• Reduced TNA may be a risk factor for trigeminal neuralgia (TN).
• Smaller TNA is associated with younger onset and the presence of trigger maneuvers in TN patients.
• Further research is warranted to elucidate the precise role of TNA in the pathogenesis of TN.