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Updated: Jul 2, 2025

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Thalamic segmentation based on diffusion tensor imaging in patients with trigeminal neuralgia.

Xinyi Li1, Hang Zhao2, Min Wang2

  • 1Department of Radiological Image, Jining Medical University, Jining 272011, China.

Brain Research
|February 27, 2024
PubMed
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Classical trigeminal neuralgia (CTN) involves structural changes in the thalamus, affecting sensory pathways. Diffusion tensor imaging revealed altered thalamic connectivity in CTN patients, aiding understanding and treatment strategies.

Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Physics

Background:

  • Classical trigeminal neuralgia (CTN) is characterized by severe facial pain within the trigeminal nerve distribution.
  • The thalamus plays a crucial role in processing sensory information, including pain signals.
  • Understanding thalamic structural changes in CTN is vital for elucidating its pathophysiology.

Purpose of the Study:

  • To investigate structural alterations in the thalamus of patients with CTN using diffusion tensor imaging (DTI).
  • To identify specific thalamic subregions and their connectivity with the cerebral cortex in CTN.
  • To correlate DTI findings with clinical parameters such as pain severity and disease duration.

Main Methods:

  • Diffusion tensor imaging (DTI) was performed on 32 CTN patients and 32 healthy controls using a 3.0 T MRI scanner.
Keywords:
Classical trigeminal neuralgiaDTIProbabilistic fiber tracking algorithmThalamic segmentation

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  • Probabilistic tracking imaging algorithms were employed to analyze structural connectivity between the thalamus and cortex.
  • Analysis focused on diffusion parameters: fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD).

    • Main Results:

    • CTN patients exhibited significantly reduced FA and increased AD, RD, and MD in the bilateral thalamus somatosensory subregion compared to controls.
    • Increased RD was observed in the frontal subregion, and increased RD and MD in the motor subregion of the thalamus in CTN patients.
    • Positive correlations were found between patient history, pain grading, and reduced FA in the somatosensory thalamus; negative correlations existed with increased RD and MD in the motor thalamus.

    Conclusions:

    • DTI reveals significant structural abnormalities and altered thalamocortical connectivity in the thalamus of CTN patients.
    • These findings enhance the understanding of CTN pathophysiology and the role of the thalamus in pain processing.
    • The study provides a thalamic segmentation atlas valuable for future deep brain stimulation (DBS) electrode placement in intractable CTN cases.