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Updated: Oct 3, 2026
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Resting-state local brain functional synchronization after a single trigger-zone stimulation: with versus without
Xiuhong Ge1, Luoyu Wang1,2, Juncheng Yan3
1Department of Radiology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No.261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province, China.
Background:
Classical trigeminal neuralgia (CTN) is characterized by transient, stimulus-evoked pain attacks, but post-stimulation changes in local brain synchronization remain unclear. We characterized static and dynamic local functional synchronization at baseline and during resting-state scans initiated after a single trigger-zone stimulation.
Methods:
Baseline analyses included 44 healthy controls (HC), 80 CTN patients with stimulation-evoked pain (CTN_pain), and 68 CTN patients without evoked pain (CTN_no_pain). Longitudinal analyses included 39 HC, 75 CTN_pain patients, and 64 CTN_no_pain patients completed all the three resting-state fMRI sessions: baseline, a scan initiated within 5 seconds after stimulation, and a scan initiated 30 minutes later. The first 20 seconds of each time series were discarded. Regional homogeneity, coherence-based regional homogeneity, and their dynamic measures (ReHo, CoReHo, dReHo, and dCoReHo) were assessed using voxel-wise group/time analyses; exploratory region of interest (ROI)-level mixed-effects models tested group × time interactions.
Results:
At baseline, group differences were observed in Frontal_Med_Orb_R, Insula_L/R, and Hippocampus_R/L. Insula_R dReHo and Frontal_Med_Orb_R ReHo differed between CTN_pain and CTN_no_pain patients. Within-group post-stimulation changes were limited in HC and broader in both CTN subgroups. Exploratory ROI-level sensitivity analyses identified seven group × time interactions that remained significant after metric-specific Bonferroni correction. Exploratory imaging-clinical analyses indicated that imaging measures associations with pain scores in CTN_pain patients and quality of life, anxiety and depression scores in CTN_no_pain patients.
Conclusions:
CTN subgroups defined by the observed pain-evocation outcome differed in baseline and temporal measures of resting-state local synchronization. Baseline Insula_R dReHo was the subgroup-associated measure but should not be interpreted as causal or predictive. Exploratory group × time interactions and imaging-clinical correlations provide preliminary evidence that requires independent replication. These findings reflect post-stimulation resting-state alterations rather than acute activation.
