AUTHOR=Liu Hao , Hou Haiman , Li Fangfang , Zheng Ruiping , Zhang Yong , Cheng Jingliang , Han Shaoqiang 

TITLE=Structural and Functional Brain Changes in Patients With Classic Trigeminal Neuralgia: A Combination of Voxel-Based Morphometry and Resting-State Functional MRI Study

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 16 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.930765

DOI=10.3389/fnins.2022.930765

ISSN=1662-453X

ABSTRACT=Objectives: Brain structural and functional abnormalities have been separately reported in patients with classic trigeminal neuralgia (CTN). However, whether and how the functional deficits are related to the structural alterations remains unclear. This study aimed to investigate the anatomical and functional deficits in CTN patients and explore their association.
Methods: Thirty-four CTN patients and twenty-nine age-, gender-matched healthy controls (HCs) were recruited. All subjects underwent structural and resting-state functional magnetic resonance imaging scanning and neuropsychological assessments. Voxel-based morphometry (VBM) was applied to characterize the alterations of gray matter volume (GMV). The amplitude of low-frequency fluctuation (ALFF) method was used to evaluate regional intrinsic spontaneous neural activity. Further correlation analyses were performed between the structural and functional changes and neuropsychological assessments.
Results: Compared to the HCs, significantly reduced GMV was revealed in the right hippocampus, right fusiform gyrus (FFG), temporal-parietal regions (the left superior/middle temporal gyrus, left operculo-insular gyrus, left inferior parietal lobule, right inferior temporal gyrus) in CTN patients. Increased functional activity measured by zALFF were observed mainly in the limbic system (the bilateral hippocampus and bilateral parahippocampal gyrus), bilateral fusiform gyrus, basal ganglia system (the bilateral putamen, bilateral caudate, and right pallidum), left thalamus, left cerebellum, midbrain, and pons. Moreover, the right hippocampus and FFG were the overlapped regions with both functional and anatomical deficits. Furthermore, GMV in the right hippocampus was negatively correlated with pain intensity, anxiety, and depression. GMV in the right FFG was negatively correlated with illness duration. The zALFF value in the right FFG was positively correlated with anxiety.
Conclusions: Our results revealed concurrent structural and functional changes in CTN patients, indicating that the CTN is a brain disorder with structural and functional abnormalities. Moreover, the overlapping structural and functional changes in the right hippocampus and FFG suggested that anatomical and functional changes might alter dependently in CTN patients. These findings highlight the vital role of hippocampus and FFG in the pathophysiology of CTN.