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Watanabe M, Shrivastava RK, Balchandani P. Advanced neuroimaging of the trigeminal nerve and the whole brain in trigeminal neuralgia: a systematic review. Pain 2024:00006396-990000000-00680. [PMID: 39132931 DOI: 10.1097/j.pain.0000000000003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/26/2024] [Indexed: 08/13/2024]
Abstract
ABSTRACT For trigeminal neuralgia (TN), a major role of imaging is to identify the causes, but recent studies demonstrated structural and microstructural changes in the affected nerve. Moreover, an increasing number of studies have reported central nervous system involvement in TN. In this systematic review, recent quantitative magnetic resonance imaging (MRI) studies of the trigeminal nerve and the brain in patients with TN were compiled, organized, and discussed, particularly emphasizing the possible background mechanisms and the interpretation of the results. A systematic search of quantitative MRI studies of the trigeminal nerve and the brain in patients with TN was conducted using PubMed. We included the studies of the primary TN published during 2013 to 2023, conducted for the assessment of the structural and microstructural analysis of the trigeminal nerve, and the structural, diffusion, and functional MRI analysis of the brain. Quantitative MRI studies of the affected trigeminal nerves and the trigeminal pathway demonstrated structural/microstructural alterations and treatment-related changes, which differentiated responders from nonresponders. Quantitative analysis of the brain revealed changes in the brain areas associated with pain processing/modulation and emotional networks. Studies of the affected nerve demonstrated evidence of demyelination and axonal damage, compatible with pathological findings, and have shown its potential value as a tool to assess treatment outcomes. Quantitative MRI has also revealed the possibility of dynamic microstructural, structural, and functional neuronal plasticity of the brain. Further studies are needed to understand these complex mechanisms of neuronal plasticity and to achieve a consensus on the clinical use of quantitative MRI in TN.
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Affiliation(s)
- Memi Watanabe
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Raj K Shrivastava
- Department of Neurosurgery, Mount Sinai Medical Center, New York, NY, United States
| | - Priti Balchandani
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Ashina S, Robertson CE, Srikiatkhachorn A, Di Stefano G, Donnet A, Hodaie M, Obermann M, Romero-Reyes M, Park YS, Cruccu G, Bendtsen L. Trigeminal neuralgia. Nat Rev Dis Primers 2024; 10:39. [PMID: 38816415 DOI: 10.1038/s41572-024-00523-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 06/01/2024]
Abstract
Trigeminal neuralgia (TN) is a facial pain disorder characterized by intense and paroxysmal pain that profoundly affects quality of life and presents complex challenges in diagnosis and treatment. TN can be categorized as classical, secondary and idiopathic. Epidemiological studies show variable incidence rates and an increased prevalence in women and in the elderly, with familial cases suggesting genetic factors. The pathophysiology of TN is multifactorial and involves genetic predisposition, anatomical changes, and neurophysiological factors, leading to hyperexcitable neuronal states, central sensitization and widespread neural plasticity changes. Neurovascular compression of the trigeminal root, which undergoes major morphological changes, and focal demyelination of primary trigeminal afferents are key aetiological factors in TN. Structural and functional brain imaging studies in patients with TN demonstrated abnormalities in brain regions responsible for pain modulation and emotional processing of pain. Treatment of TN involves a multifaceted approach that considers patient-specific factors, including the type of TN, with initial pharmacotherapy followed by surgical options if necessary. First-line pharmacological treatments include carbamazepine and oxcarbazepine. Surgical interventions, including microvascular decompression and percutaneous neuroablative procedures, can be considered at an early stage if pharmacotherapy is not sufficient for pain control or has intolerable adverse effects or contraindications.
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Affiliation(s)
- Sait Ashina
- BIDMC Comprehensive Headache Center, Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- BIDMC Comprehensive Headache Center, Department of Anaesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | | | - Anan Srikiatkhachorn
- Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Giulia Di Stefano
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Anne Donnet
- Department of Evaluation and Treatment of Pain, FHU INOVPAIN, Centre Hospitalier Universitaire de Marseille, Hopital de la Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Mojgan Hodaie
- Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontairo, Canada
| | - Mark Obermann
- Department of Neurology, Hospital Weser-Egge, Hoexter, Germany
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Marcela Romero-Reyes
- Department of Pain and Neural Sciences, Brotman Facial Pain Clinic, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Young Seok Park
- Department of Medical Neuroscience, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
- Department of Neurosurgery, Gamma Knife Icon Center, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Giorgio Cruccu
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Lars Bendtsen
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, University of Copenhagen, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Copenhagen, Denmark
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Wang Z, Zhao Z, Song Z, Xu J, Wang Y, Zhao Z, Li Y. Functional alterations of the brain default mode network and somatosensory system in trigeminal neuralgia. Sci Rep 2024; 14:10205. [PMID: 38702383 PMCID: PMC11068897 DOI: 10.1038/s41598-024-60273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024] Open
Abstract
Mapping the localization of the functional brain regions in trigeminal neuralgia (TN) patients is still lacking. The study aimed to explore the functional brain alterations and influencing factors in TN patients using functional brain imaging techniques. All participants underwent functional brain imaging to collect resting-state brain activity. The significant differences in regional homogeneity (ReHo) and amplitude of low frequency (ALFF) between the TN and control groups were calculated. After familywise error (FWE) correction, the differential brain regions in ReHo values between the two groups were mainly located in bilateral middle frontal gyrus, bilateral inferior cerebellum, right superior orbital frontal gyrus, right postcentral gyrus, left inferior temporal gyrus, left middle temporal gyrus, and left gyrus rectus. The differential brain regions in ALFF values between the two groups were mainly located in the left triangular inferior frontal gyrus, left supplementary motor area, right supramarginal gyrus, and right middle frontal gyrus. With the functional impairment of the central pain area, the active areas controlling memory and emotion also change during the progression of TN. There may be different central mechanisms in TN patients of different sexes, affected sides, and degrees of nerve damage. The exact central mechanisms remain to be elucidated.
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Affiliation(s)
- Zairan Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, China
| | - Zijun Zhao
- Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Zihan Song
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiayi Xu
- Medical Records Room, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yizheng Wang
- Department of Pain Rehabilitation, The Forth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zongmao Zhao
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, China.
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Yan J, Wang L, Pan L, Ye H, Zhu X, Feng Q, Wang H, Ding Z, Ge X. Altered trends of local brain function in classical trigeminal neuralgia patients after a single trigger pain. BMC Med Imaging 2024; 24:66. [PMID: 38500069 PMCID: PMC10949736 DOI: 10.1186/s12880-024-01239-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To investigate the altered trends of regional homogeneity (ReHo) based on time and frequency, and clarify the time-frequency characteristics of ReHo in 48 classical trigeminal neuralgia (CTN) patients after a single pain stimulate. METHODS All patients underwent three times resting-state functional MRI (before stimulation (baseline), after stimulation within 5 s (triggering-5 s), and in the 30th min of stimulation (triggering-30 min)). The spontaneous brain activity was investigated by static ReHo (sReHo) in five different frequency bands and dynamic ReHo (dReHo) methods. RESULTS In the five frequency bands, the number of brain regions which the sReHo value changed in classical frequency band were most, followed by slow 4 frequency band. The left superior occipital gyrus was only found in slow 2 frequency band and the left superior parietal gyrus was only found in slow 3 frequency band. The dReHo values were changed in midbrain, left thalamus, right putamen, and anterior cingulate cortex, which were all different from the brain regions that the sReHo value altered. There were four altered trends of the sReHo and dReHo, which dominated by decreased at triggering-5 s and increased at triggering-30 min. CONCLUSIONS The duration of brain function changed was more than 30 min after a single pain stimulate, although the pain of CTN was transient. The localized functional homogeneity has time-frequency characteristic in CTN patients after a single pain stimulate, and the changed brain regions of the sReHo in five frequency bands and dReHo complemented to each other. Which provided a certain theoretical basis for exploring the pathophysiology of CTN.
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Affiliation(s)
- Juncheng Yan
- Department of Rehabilitation, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Hangzhou First People's Hospital, 310006, Hangzhou, China
| | - Lei Pan
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Haiqi Ye
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Xiaofen Zhu
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Haibin Wang
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Hangzhou First People's Hospital, 310006, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, 310000, Hangzhou, China.
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Hangzhou First People's Hospital, 310006, Hangzhou, China.
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Ge X, Wang L, Yan J, Pan L, Ye H, Zhu X, Feng Q, Chen B, Du Q, Yu W, Ding Z. Altered brain function in classical trigeminal neuralgia patients: ALFF, ReHo, and DC static- and dynamic-frequency study. Cereb Cortex 2024; 34:bhad455. [PMID: 38012118 DOI: 10.1093/cercor/bhad455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/02/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023] Open
Abstract
The present study aimed to clarify the brain function of classical trigeminal neuralgia (CTN) by analyzing 77 CTN patients and age- and gender-matched 73 healthy controls (HCs) based on three frequency bands of the static and dynamic amplitude of low-frequency fluctuation, regional homogeneity, and degree centrality (sALFF, sReHo, sDC, dALFF, dReHo, and dDC). Compared to HCs, the number of altered brain regions was different in three frequency bands, and the classical frequency band was most followed by slow-4 in CTN patients. Cerrelellum_8_L (sReHo), Cerrelellum_8_R (sDC), Calcarine_R (sDC), and Caudate_R (sDC) were found only in classical frequency band, while Precuneus_L (sALFF) and Frontal_Inf_Tri_L (sReHo) were found only in slow-4 frequency band. Except for the above six brain regions, the others overlapped in the classical and slow-4 frequency bands. CTN seriously affects the mental health of patients, and some different brain regions are correlated with clinical parameters. The static and dynamic indicators of brain function were complementary in CTN patients, and the changing brain regions showed frequency specificity. Compared to slow-5 frequency band, slow-4 is more consistent with the classical frequency band, which could be valuable in exploring the pathophysiology of CTN.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Juncheng Yan
- Department of Rehabilitation, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Lei Pan
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Haiqi Ye
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Xiaofen Zhu
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Bing Chen
- Jing Hengyi School of Education, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Yuhang District, Hangzhou City, Zhejiang Province 311121, China
| | - Quan Du
- Department of Neurosurgery, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Wenhua Yu
- Department of Neurosurgery, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, No. 261, Huansha Road, Shangcheng District, Hangzhou City, Zhejiang Province 310000, China
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Huang X, Li B, Li Y, Lin J, Shang H, Yang J. A multimodal meta-analysis of gray matter alterations in trigeminal neuralgia. Front Neurol 2023; 14:1179896. [PMID: 37602249 PMCID: PMC10436096 DOI: 10.3389/fneur.2023.1179896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Background Brain gray matter alterations in patients with trigeminal neuralgia (TN) have been detected in prior neuroimaging studies, but the results are heterogeneous. The current study conducted coordinate-based meta-analyses across neuroimaging studies, aiming to find the pattern of brain anatomic and functional alterations in patients with TN. Methods We performed a systematic literature search of PubMed, Embase, and Web of Science to identify relevant publications. A multimodal meta-analysis for whole-brain voxel-based morphometry (VBM) studies and functional imaging studies in TN was performed using anisotropic effect size-based signed differential mapping. Results The meta-analysis comprised 10 VBM studies with 398 TN patients and 275 healthy controls, and 13 functional magnetic resonance imaging studies with 307 TN patients and 264 healthy controls. The multimodal meta-analysis showed conjoint structural and functional brain alterations in the right fusiform gyrus and inferior temporal gyrus, bilateral thalamus, left superior temporal gyrus, left insula, and inferior frontal gyrus. The unimodal meta-analysis showed decreased gray matter volume alone in the left putamen, left postcentral gyrus, and right amygdala as well as only functional abnormalities in the left cerebellum, bilateral precuneus, and left middle temporal gyrus. Conclusion This meta-analysis revealed overlapping anatomic and functional gray matter abnormalities in patients with TN, which may help provide new insights into the neuropathology and potential treatment biomarkers of TN.
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Affiliation(s)
- Xiang Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Boyi Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuming Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Junyu Lin
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Liang Y, Zhao Q, Hu Z, Bo K, Meyyappan S, Neubert JK, Ding M. Imaging the neural substrate of trigeminal neuralgia pain using deep learning. Front Hum Neurosci 2023; 17:1144159. [PMID: 37275345 PMCID: PMC10232768 DOI: 10.3389/fnhum.2023.1144159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/04/2023] [Indexed: 06/07/2023] Open
Abstract
Trigeminal neuralgia (TN) is a severe and disabling facial pain condition and is characterized by intermittent, severe, electric shock-like pain in one (or more) trigeminal subdivisions. This pain can be triggered by an innocuous stimulus or can be spontaneous. Presently available therapies for TN include both surgical and pharmacological management; however, the lack of a known etiology for TN contributes to the unpredictable response to treatment and the variability in long-term clinical outcomes. Given this, a range of peripheral and central mechanisms underlying TN pain remain to be understood. We acquired functional magnetic resonance imaging (fMRI) data from TN patients who (1) rested comfortably in the scanner during a resting state session and (2) rated their pain levels in real time using a calibrated tracking ball-controlled scale in a pain tracking session. Following data acquisition, the data was analyzed using the conventional correlation analysis and two artificial intelligence (AI)-inspired deep learning methods: convolutional neural network (CNN) and graph convolutional neural network (GCNN). Each of the three methods yielded a set of brain regions related to the generation and perception of pain in TN. There were 6 regions that were identified by all three methods, including the superior temporal cortex, the insula, the fusiform, the precentral gyrus, the superior frontal gyrus, and the supramarginal gyrus. Additionally, 17 regions, including dorsal anterior cingulate cortex (dACC) and the thalamus, were identified by at least two of the three methods. Collectively, these 23 regions are taken to represent signature centers of TN pain and provide target areas for future studies seeking to understand the central mechanisms of TN.
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Affiliation(s)
- Yun Liang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Qing Zhao
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Zhenhong Hu
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Ke Bo
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Sreenivasan Meyyappan
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
| | - John K. Neubert
- Department of Orthodontics, University of Florida, Gainesville, FL, United States
| | - Mingzhou Ding
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
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Yu XM, Lv WM, Liu XL, Kang XZ, Zhang LW. Abnormal activation of brain regions in idiopathic trigeminal neuralgia patients by fMRI: An activation likelihood estimation meta-analysis. Clin Neurol Neurosurg 2023; 228:107710. [PMID: 37043845 DOI: 10.1016/j.clineuro.2023.107710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Idiopathic trigeminal neuralgia (ITN) is one of the most common types of neuropathic pain, severely affecting the physiological and psychological wellbeing of patients. Recently, fMRI has been used to examine abnormal activation of brain regions in patients with ITN. However, sample sizes have been small in these few studies, and the abnormally activated brain regions remain unclear. Therefore, in the present study, we retrieved and analyzed literature on the brain areas with abnormal or reduced activation in ITN patients, with the aim of providing insight into the neuropathological basis of the disease and to provide new targets for treatment. METHODS We retrieved resting state fMRI studies on trigeminal neuralgia patients from PubMed, the Web of Science and Scopus databases until November 2022, and we extracted the coordinates of the sites with increased or decreased activation. We used activation likelihood estimation (ALE) meta-analysis to identify regions of abnormal activation in ITN patients. RESULTS ALE meta-analysis revealed that the left caudate nucleus and right anterior ventral nucleus of the thalamus are abnormally hyperactivated in ITN patients. Moreover, ITN patients showed reduced activation in the left precuneus, middle temporal gyrus, lingual gyrus, and medial frontal gyrus. CONCLUSION ALE meta-analysis identified several brain regions with abnormally high or decreased activation in ITN patients. Sites with altered activation may be potential targets for non-invasive brain stimulation as adjunct therapy for ITN.
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Affiliation(s)
- Xin-Ming Yu
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wen-Ming Lv
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shandong Institute of Brain Science and Brain-inspired Research, Jinan, Shandong, China; Department of Neurosurgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong, China
| | - Xiao-Liang Liu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shandong Institute of Brain Science and Brain-inspired Research, Jinan, Shandong, China; Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xi-Zhi Kang
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Liang-Wen Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shandong Institute of Brain Science and Brain-inspired Research, Jinan, Shandong, China.
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Liu H, Zheng R, Zhang Y, Zhang B, Hou H, Cheng J, Han S. Alterations of degree centrality and functional connectivity in classic trigeminal neuralgia. Front Neurosci 2023; 16:1090462. [PMID: 36699513 PMCID: PMC9870176 DOI: 10.3389/fnins.2022.1090462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Objectives Recent neuroimaging studies have indicated a wide range of structural and regional functional alterations in patients with classic trigeminal neuralgia (CTN). However, few studies have focused on the intrinsic functional characteristics of network organization in the whole brain. Therefore, the present study aimed to characterize the potential intrinsic dysconnectivity pattern of the whole brain functional networks at the voxel level using the degree centrality (DC) analysis in CTN patients. Methods Thirty-four patients with CTN and twenty-nine well-matched healthy controls (HCs) participated in this study. All subjects underwent resting-state functional magnetic resonance imaging (rs-MRI) examination and clinical and neuropsychologic assessments. DC is a graph theory-based measurement that represents the overall functional connectivity (FC) numbers between one voxel and other brain voxels. We first investigated brain regions exhibiting abnormal DC, and further identified their perturbation on FC with other brain regions using a seed-based FC analysis in patients with CTN. In addition, correlation analyses were performed to evaluate the relationship between the abnormal DC value and clinical variables in CTN patients. Results Compared with the HCs, the patients with CTN exhibited significantly greater DC values in the right pallidum and right putamen, and lower DC values in the right lingual gyrus, right calcarine sulcus, left paracentral lobule, and left midcingulate cortex. A further seed-based FC analysis revealed that the right lingual gyrus showed decreased FC within the visual network and with other core brain networks, including the sensorimotor network, default mode network, and salience network, relative to HCs. Additionally, the left midcingulate cortex exhibited decreased FC within the middle cingulate cortex and the visual network in CTN patients. Moreover, the DC value in the left midcingulate cortex was negatively correlated with the illness duration. Conclusion The present study shows that CTN patients exhibited specific functional connectivity network alterations in the basal ganglia, visual network, and salience network, which may reflect the aberrant neural network communication in pain processing and modulation. These findings may provide novel insight for understanding the mechanisms of pain chronicity in CTN patients.
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Affiliation(s)
- Hao Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Beibei Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Haiman Hou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Haiman Hou,
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China,Jingliang Cheng,
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China,Shaoqiang Han,
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Ge X, Wang L, Wang M, Pan L, Ye H, Zhu X, Fan S, Feng Q, Du Q, Wenhua Y, Ding Z. Alteration of brain network centrality in CTN patients after a single triggering pain. Front Neurosci 2023; 17:1109684. [PMID: 36875648 PMCID: PMC9978223 DOI: 10.3389/fnins.2023.1109684] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Objective The central nervous system may also be involved in the pathogenesis of classical trigeminal neuralgia (CTN). The present study aimed to explore the characteristics of static degree centrality (sDC) and dynamic degree centrality (dDC) at multiple time points after a single triggering pain in CTN patients. Materials and methods A total of 43 CTN patients underwent resting-state function magnetic resonance imaging (rs-fMRI) before triggering pain (baseline), within 5 s after triggering pain (triggering-5 s), and 30 min after triggering pain (triggering-30 min). Voxel-based degree centrality (DC) was used to assess the alteration of functional connection at different time points. Results The sDC values of the right caudate nucleus, fusiform gyrus, middle temporal gyrus, middle frontal gyrus, and orbital part were decreased in triggering-5 s and increased in triggering-30 min. The sDC value of the bilateral superior frontal gyrus were increased in triggering-5 s and decreased in triggering-30 min. The dDC value of the right lingual gyrus was gradually increased in triggering-5 s and triggering-30 min. Conclusion Both the sDC and dDC values were changed after triggering pain, and the brain regions were different between the two parameters, which supplemented each other. The brain regions which the sDC and dDC values were changing reflect the global brain function of CTN patients, and provides a basis for further exploration of the central mechanism of CTN.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China.,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, The Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China.,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, The Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengze Wang
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China.,Department of Radiology, The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lei Pan
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China
| | - Haiqi Ye
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China
| | - Xiaofen Zhu
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sandra Fan
- Department of Radiology, The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qi Feng
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quan Du
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, The Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Wenhua
- Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, The Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Jiangsu, China.,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, The Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China
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11
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Jin Y, Li F, Yang H, Long H, Gong Q, Lai W. Altered spontaneous neural activity in experimental odontogenic pain: a resting-state functional MRI study. Am J Transl Res 2022; 14:8398-8406. [PMID: 36505321 PMCID: PMC9730070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to evaluate the intrinsic cerebral activity alternations in experimental odontogenic pain with resting-state functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS Forty-nine participants in an odontogenic pain group and 49 participants in control group underwent imaging using fMRI in this prospective study. Odontogenic pain was induced by experimental tooth movement. We calculated the fractional amplitude of low-frequency fluctuation (fALFF) value to evaluate regional cerebral function and compared it between the two groups utilizing a voxel-based two-sample t-test. RESULTS In comparison with the healthy controls, the participants in odontogenic pain group showed increased fALFF value in the left cerebellum, right posterior cingulate gyrus, and bilateral inferior temporal gyrus, as well as decreased fALFF in the medial prefrontal cortex, the left anterior cingulate cortex, bilateral angular gyrus, left inferior parietal cortex, middle temporal gyrus, and miscellaneous cerebral regions (P < 0.001 familywise error-corrected VOXEL > 100). CONCLUSION The present study showed abnormal cerebral activity in odontogenic pain, and reveled that the aberrant regional functional activities were mainly located within the default mode network. The finding could provide insight into the underlying neural mechanism of odontogenic pain. Registry of clinical trials (Trial number ChiCTR1800018589) - http://www.chictr.org.cn/showproj.aspx?proj=31424.
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Affiliation(s)
- Yu Jin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan UniversityChengdu, Sichuan, P. R. China,Unit of Psychoradiology, Chinese Academy of Medical SciencesChengdu 610041, Sichuan, P. R. China
| | - Hong Yang
- School of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, P. R. China
| | - Hu Long
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan UniversityChengdu, Sichuan, P. R. China,Unit of Psychoradiology, Chinese Academy of Medical SciencesChengdu 610041, Sichuan, P. R. China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
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12
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Altered spontaneous brain activity in Down syndrome and its relation with cognitive outcome. Sci Rep 2022; 12:15410. [PMID: 36104362 PMCID: PMC9474876 DOI: 10.1038/s41598-022-19627-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractAlthough Down syndrome (DS) is the most common genetic cause of neurodevelopmental delay, few neuroimaging studies have explored this population. This investigation aimed to study whole-brain resting-state spontaneous brain activity using fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) strategies to find differences in spontaneous brain activity among young people with DS and controls and to correlate these results with cognitive outcomes. The sample comprised 18 persons with DS (age mean = 28.67, standard deviation = 4.18) and 18 controls (age mean = 28.56, standard deviation = 4.26). fALFF and ReHo analyses were performed, and the results were correlated with other cognitive variables also collected (KBIT-2 and verbal fluency test). Increased activity was found in DS using fALFF in areas involving the frontal and temporal lobes and left cerebellum anterior lobe. Decreased activity in DS was found in the left parietal and occipital lobe, the left limbic lobe and the left cerebellum posterior lobe. ReHo analysis showed increased activity in certain DS areas of the left frontal lobe and left rectus, as well as the inferior temporal lobe. The areas with decreased activity in the DS participants were regions of the frontal lobe and the right limbic lobe. Altered fALFF and ReHo were found in the DS population, and this alteration could predict the cognitive abilities of the participants. To our knowledge, this is the first study to explore regional spontaneous brain activity in a population with DS. Moreover, this study suggests the possibility of using fALFF and ReHo as biomarkers of cognitive function, which is highly important given the difficulties in cognitively evaluating this population to assess dementia. More research is needed, however, to demonstrate its utility.
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13
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Ge X, Wang L, Pan L, Ye H, Zhu X, Fan S, Feng Q, Yu W, Ding Z. Amplitude of low-frequency fluctuation after a single-trigger pain in patients with classical trigeminal neuralgia. J Headache Pain 2022; 23:117. [PMID: 36076162 PMCID: PMC9461270 DOI: 10.1186/s10194-022-01488-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Abstract
Objective This study aimed to explore the central mechanism of classical trigeminal neuralgia (CTN) by analyzing the static amplitude of low-frequency fluctuation (sALFF) and dynamic amplitude of low-frequency fluctuation (dALFF) in patients with CTN before and after a single-trigger pain. Methods This study included 48 patients (37 women and 11 men, age 55.65 ± 11.41 years) with CTN. All participants underwent 3D-T1WI and three times resting-state functional magnetic resonance imaging. The images were taken before stimulating the trigger zone (baseline), within 5 s after stimulating the trigger zone (triggering-5 s), and in the 30th minute after stimulating the trigger zone (triggering-30 min). The differences between the three measurements were analyzed using a repeated-measures analysis of variance. Results The sALFF values of the bilateral middle occipital gyrus and right cuneus gradually increased, and the values of the left posterior cingulum gyrus and bilateral superior frontal gyrus gradually decreased in triggering-5 s and triggering-30 min. The values of the right middle temporal gyrus and right thalamus decreased in triggering-5 s and subsequently increased in triggering-30 min. The sALFF values of the left superior temporal gyrus increased in triggering-5 s and then decreased in triggering-30 min. The dALFF values of the right fusiform gyrus, bilateral lingual gyrus, left middle temporal gyrus, and right cuneus gyrus gradually increased in both triggering-5 s and triggering-30 min. Conclusions The sALFF and dALFF values changed differently in multiple brain regions in triggering-5 s and triggering-30 min of CTN patients after a single trigger of pain, and dALFF is complementary to sALFF. The results might help explore the therapeutic targets for relieving pain and improving the quality of life of patients with CTN. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01488-8.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China.,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou City, 310006, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China.,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou City, 310006, China
| | - Lei Pan
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China
| | - Haiqi Ye
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China
| | - Xiaofen Zhu
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China
| | - Sandra Fan
- Zhejiang Chinese Medical University, Hangzhou, 310000, P.R. China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China
| | - Wenhua Yu
- Department of Neurosurgery, Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261, Huansha Road, Shangcheng Distric, Hangzhou, 310000, P.R. China.
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, P.R. China. .,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou City, 310006, China.
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14
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Wang Z, Zhao Z, Song Z, Wang Y, Zhao Z. The application of magnetic resonance imaging (MRI) for the prediction of surgical outcomes in trigeminal neuralgia. Postgrad Med 2022; 134:480-486. [PMID: 35503235 DOI: 10.1080/00325481.2022.2067612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Trigeminal neuralgia (TN) is a severe facial pain disorder that often requires surgical treatment. Neurovascular compression (NVC) has been widely accepted as the primary cause of classical TN (cTN). Vascular compression involving the near half of the cisternal segment of trigeminal nerve was the most likely cause of patient's symptoms. And severe NVC was a strong imaging predictor of an optimal surgical outcome. Operative treatments for cTN include microvascular decompression (MVD) and various ablative procedures. However, a significant proportion of cTN patients with significant NVC fail to achieve long-term pain relief after technically successful surgery. Neuroimaging using magnetic resonance imaging (MRI) provides a noninvasive method to generate objective biomarkers of eventual response to TN surgery. This paper reviewed the progress of research on the prediction of surgical outcomes in TN with MRI.
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Affiliation(s)
- Zairan Wang
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zijun Zhao
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zihan Song
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Yizheng Wang
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zongmao Zhao
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
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15
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Wang XY, Tan H, Li X, Dai LQ, Zhang ZW, Lv FJ, Yu RQ. Resting-state functional magnetic resonance imaging-based identification of altered brain the fractional amplitude of low frequency fluctuation in adolescent major depressive disorder patients undergoing electroconvulsive therapy. Front Psychiatry 2022; 13:972968. [PMID: 35958635 PMCID: PMC9357980 DOI: 10.3389/fpsyt.2022.972968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/05/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE While electroconvulsive therapy (ECT) has been repeatedly been shown to effectively and efficiently treat the major depressive disorder (MDD), the mechanistic basis for such therapeutic efficacy remains to be firmly established. As such, further research exploring the ECT-based treatment of MDD in an adolescent population is warranted. METHODS This study included 30 treatment-naïve first-episode MDD patients and 30 healthy control (HC) individuals (aged 12-17 years). All participants were scanned using rs-fMRI, and the 30 MDD patients were scanned again after 2 weeks of the ECT treatment period. Intrinsic local activity in each voxel was assessed based on the fractional amplitude of low frequency fluctuation (fALFF) parameter, with all fALFF analyses being completed using the REST application. Correlations between ECT-related changes in fALFF and clinical parameters were additionally examined. RESULTS Relative to HCs, MDD patients exhibited increased fALFF values in the right inferior frontal gyrus (ORBinf), inferior occipital gyrus (IOG), and the left middle frontal gyrus (MFG) at baseline. Following ECT, these patients exhibited significant increases in fALFF values in the right medial superior frontal gyrus (SFGmed), dorsolateral superior frontal gyrus (SFGdor), anterior cingulate, and paracingulate gyrus (ACG), median cingulate and paracingulate gyrus (DCG), and left MFG. MDD patient HAMD scores were negatively correlated with fALFF values when analyzing pre-ECT vs. post-HCT ΔHAMD and fALFF values in the right SFGmed, SFGdor, and the left MFG. CONCLUSION These data suggest that ECT induced altered fALFF in some regions of the brain, suggesting that these alterations may serve as a neurobiological indicator of ECT effectiveness in MDD adolescents.
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Affiliation(s)
- Xing-Yu Wang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huan Tan
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin-Qi Dai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhi-Wei Zhang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fa-Jin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ren-Qiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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16
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Tang D, Zhang X, Xu Y, Dai L, Sun J, Hu H, Jiang H, Jin P, Chen L, Fang J. The Central Response of Electroacupuncture on Trigeminal Neuralgia Based on Resting-State Functional Magnetic Resonance Imaging: A Protocol for a Pre-Experimental, Single-Centre, Randomized, Controlled Trial. J Pain Res 2021; 14:3321-3331. [PMID: 34707400 PMCID: PMC8543029 DOI: 10.2147/jpr.s334078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To verify the efficacy of electroacupuncture (EA) on classical trigeminal neuralgia (CTN), and to observe the brain functional status of patients with CTN and the intervention effects of EA on brain function by resting-state functional magnetic resonance imaging (rs-fMRI). Methods and Analysis Thirty CTN patients will be randomly divided into EA combined with carbamazepine group and carbamazepine group in 2:1 ratio by using a random number table. Patients in EA combined with carbamazepine will receive EA treatment and carbamazepine for four weeks. The carbamazepine group will only receive carbamazepine treatment. VAS (visual analogue scale), HAMA (Hamilton Anxiety Scale), HAMD (Hamilton Depression Scale) and SF-36 (short form 36 health survey) will be performed before, after four-week treatments and at three-month follow-up in CTN patients. Six CTN patients will be randomly selected from EA combined with carbamazepine group and carbamazepine group, respectively, before treatment, and twelve paired healthy participants will be recruited at the same time. The twelve CTN patients will be scanned by rs-fMRI before and after treatment, and the healthy participants will be scanned by rs-fMRI only at baseline. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analysis will be carried out to compare the dysfunctional brain regions between CTN patients and healthy participants, as well as the differences between two groups of patients with CTN after treatment. Trial Registration ChiCTR-1900027873.
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Affiliation(s)
- Ding Tang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Xufen Zhang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Yani Xu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Linglin Dai
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianlan Sun
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Hantong Hu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Huangwei Jiang
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Ping Jin
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Lifang Chen
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianqiao Fang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
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17
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Zhang S, Li H, Xu Q, Wang C, Li X, Sun J, Wang Y, Sun T, Wang Q, Zhang C, Wang J, Jia X, Sun X. Regional homogeneity alterations in multi-frequency bands in tension-type headache: a resting-state fMRI study. J Headache Pain 2021; 22:129. [PMID: 34711175 PMCID: PMC8555254 DOI: 10.1186/s10194-021-01341-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the spontaneous neural activity in the conventional frequency band (0.01-0.08 Hz) and two sub-frequency bands (slow-4: 0.027-0.073 Hz, and slow-5: 0.01-0.027 Hz) in tension-type headache (TTH) patients with regional homogeneity (ReHo) analyses. METHODS Thirty-eight TTH patients and thirty-eight healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (RS-fMRI) scanning to investigate abnormal spontaneous neural activity using ReHo analysis in conventional frequency band (0.01-0.08 Hz) and two sub-frequency bands (slow-4: 0.027-0.073 Hz and slow-5: 0.01-0.027 Hz). RESULTS In comparison with the HC group, patients with TTH exhibited ReHo increases in the right medial superior frontal gyrus in the conventional frequency band (0.01-0.08 Hz). The between group differences in the slow-5 band (0.01-0.027 Hz) highly resembled the differences in the conventional frequency band (0.01-0.08 Hz); even the voxels with increased ReHo were spatially more extensive, including the right medial superior frontal gyrus and the middle frontal gyrus. In contrast, no region showed significant between-group differences in the slow-4 band (0.027-0.073 Hz). The correlation analyses showed no correlation between the ReHo values in TTH patients and VAS scores, course of disease and number of seizures per month in conventional band (0.01-0.08 Hz), slow-4 band (0.027-0.073 Hz), as well as in slow-5 band (0.01-0.027 Hz). CONCLUSIONS The results showed that the superior frontal gyrus and middle frontal gyrus were involved in the integration and processing of pain signals. In addition, the abnormal spontaneous neural activity in TTH patients was frequency-specific. Namely, slow-5 band (0.01-0.027 Hz) might contain additional useful information in comparison to slow-4 band (0.027-0.073 Hz). This preliminary exploration might provide an objective imaging basis for the understanding of the pathophysiological mechanism of TTH.
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Affiliation(s)
- Shuxian Zhang
- Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China
| | - Huayun Li
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Qinyan Xu
- Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China
| | - Chao Wang
- Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China
| | - Xue Li
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Yaqi Wang
- Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong Province, China
| | - Tong Sun
- Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong Province, China
| | - Qianqian Wang
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Chengcheng Zhang
- Department of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, China
| | - Jili Wang
- Department of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, China
| | - Xize Jia
- Centre for Cognition and Brain disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
| | - Xihe Sun
- Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China.
- Department of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, China.
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18
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Regional brain morphology predicts pain relief in trigeminal neuralgia. NEUROIMAGE-CLINICAL 2021; 31:102706. [PMID: 34087549 PMCID: PMC8184658 DOI: 10.1016/j.nicl.2021.102706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022]
Abstract
Regional brain gray matter morphology robustly predict TN radiosurgery response. Surface area ML model was 96.7% accurate, 100.0% sensitive, and 89.1% specific. Top predictor for surface area model was contralateral superior frontal gyrus. Cortical thickness ML model was 90.5% accurate, 93.5% sensitive, and 83.7% specific. Top predictor for cortical thickness model was contralateral isthmus cingulate gyrus.
Background Trigeminal neuralgia, a severe chronic neuropathic pain disorder, is widely believed to be amenable to surgical treatments. Nearly 20% of patients, however, do not have adequate pain relief after surgery. Objective tools for personalized pre-treatment prognostication of pain relief following surgical interventions can minimize unnecessary surgeries and thus are of substantial benefit for patients and clinicians. Purpose To determine if pre-treatment regional brain morphology-based machine learning models can prognosticate 1 year response to Gamma Knife radiosurgery for trigeminal neuralgia. Methods We used a data-driven approach that combined retrospective structural neuroimaging data and support vector machine-based machine learning to produce robust multivariate prediction models of pain relief following Gamma Knife radiosurgery for trigeminal neuralgia. Surgical response was defined as ≥ 75% pain relief 1 year post-treatment. We created two prediction models using pre-treatment regional brain gray matter morphology (cortical thickness or surface area) to distinguish responders from non-responders to radiosurgery. Feature selection was performed through sequential backwards selection algorithm. Model out-of-sample generalizability was estimated via stratified 10-fold cross-validation procedure and permutation testing. Results In 51 trigeminal neuralgia patients (35 responders, 16 non-responders), machine learning models based on pre-treatment regional brain gray matter morphology (14 regional surface areas or 13 regional cortical thicknesses) provided robust a priori prediction of surgical response. Cross-validation revealed the regional surface area model was 96.7% accurate, 100.0% sensitive, and 89.1% specific while the regional cortical thickness model was 90.5% accurate, 93.5% sensitive, and 83.7% specific. Permutation testing revealed that both models performed beyond pure chance (p < 0.001). The best predictor for regional surface area model and regional cortical thickness model was contralateral superior frontal gyrus and contralateral isthmus cingulate gyrus, respectively. Conclusions Our findings support the use of machine learning techniques in subsequent investigations of chronic neuropathic pain. Furthermore, our multivariate framework provides foundation for future development of generalizable, artificial intelligence-driven tools for chronic neuropathic pain treatments.
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Voxel-Wise Brain-Wide Functional Connectivity Abnormalities in Patients with Primary Blepharospasm at Rest. Neural Plast 2021; 2021:6611703. [PMID: 33505457 PMCID: PMC7808842 DOI: 10.1155/2021/6611703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022] Open
Abstract
Background Primary blepharospasm (BSP) is one of the most common focal dystonia and its pathophysiological mechanism remains unclear. An unbiased method was used in patients with BSP at rest to observe voxel-wise brain-wide functional connectivity (FC) changes. Method A total of 48 subjects, including 24 untreated patients with BSP and 24 healthy controls, were recruited to undergo functional magnetic resonance imaging (fMRI). The method of global-brain FC (GFC) was adopted to analyze the resting-state fMRI data. We designed the support vector machine (SVM) method to determine whether GFC abnormalities could be utilized to distinguish the patients from the controls. Results Relative to healthy controls, patients with BSP showed significantly decreased GFC in the bilateral superior medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC) and increased GFC in the right postcentral gyrus/precentral gyrus/paracentral lobule, right superior frontal gyrus (SFG), and left paracentral lobule/supplement motor area (SMA), which were included in the default mode network (DMN) and sensorimotor network. SVM analysis showed that increased GFC values in the right postcentral gyrus/precentral gyrus/paracentral lobule could discriminate patients from controls with optimal accuracy, specificity, and sensitivity of 83.33%, 83.33%, and 83.33%, respectively. Conclusion This study suggested that abnormal GFC in the brain areas associated with sensorimotor network and DMN might underlie the pathophysiology of BSP, which provided a new perspective to understand BSP. GFC in the right postcentral gyrus/precentral gyrus/paracentral lobule might be utilized as a latent biomarker to differentiate patients with BSP from controls.
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20
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Lin X, Zhen D, Li H, Zhong J, Dai Z, Yuan C, Pan P. Altered local connectivity in chronic pain: A voxel-wise meta-analysis of resting-state functional magnetic resonance imaging studies. Medicine (Baltimore) 2020; 99:e21378. [PMID: 32756127 PMCID: PMC7402869 DOI: 10.1097/md.0000000000021378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A number of studies have used regional homogeneity (ReHo) to depict local functional connectivity in chronic pain (CP). However, the findings from these studies were mixed and inconsistent. METHODS A computerized literature search will be performed in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WanFang, and SinoMed databases until June 15, 2019 and updated on March 20, 2020. This protocol will follow the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P). The Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software will be used for this voxel-wise meta-analysis. RESULTS This meta-analysis will identify the most consistent ReHo alterations in CP. CONCLUSIONS To our knowledge, this will be the first voxel-wise meta-analysis that integrates ReHo findings in CP. This meta-analysis will offer the quantitative evidence of ReHo alterations that characterize brain local functional connectivity of CP. PROSPERO REGISTRATION NUMBER CRD42019148523.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu
| | - Dan Zhen
- Jiangsu Vocational College of Medicine
| | | | | | | | - CongHu Yuan
- Department of Anesthesia and Pain Management
| | - PingLei Pan
- Department of Neurology
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, P.R. China
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21
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Zhu PW, Chen Y, Gong YX, Jiang N, Liu WF, Su T, Ye L, Min YL, Yuan Q, He LC, Shao Y. Altered brain network centrality in patients with trigeminal neuralgia: a resting-state fMRI study. Acta Radiol 2020; 61:67-75. [PMID: 31088124 DOI: 10.1177/0284185119847678] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Neuroimaging studies revealed that trigeminal neuralgia was related to alternations in brain anatomical function and regional function. However, the functional characteristics of network organization in the whole brain is unknown. Purpose The aim of the present study was to analyze potential functional network brain-activity changes and their relationships with clinical features in patients with trigeminal neuralgia via the voxel-wise degree centrality method. Material and Methods This study involved a total of 28 trigeminal neuralgia patients (12 men, 16 women) and 28 healthy controls matched in sex, age, and education. Spontaneous brain activity was evaluated by degree centrality. Correlation analysis was used to examine the correlations between behavioral performance and average degree centrality values in several brain regions. Results Compared with healthy controls, trigeminal neuralgia patients had significantly higher degree centrality values in the right lingual gyrus, right postcentral gyrus, left paracentral lobule, and bilateral inferior cerebellum. Receiver operative characteristic curve analysis of each brain region confirmed excellent accuracy of the areas under the curve. There was a positive correlation between the mean degree centrality value of the right postcentral gyrus and VAS score (r = 0.885, P < 0.001). Conclusions Trigeminal neuralgia causes abnormal brain network activity in multiple brain regions, which may be related to underlying disease mechanisms.
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Affiliation(s)
- Pei-Wen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - You Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Ying-Xin Gong
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Nan Jiang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian Province, PR China
| | - Wen-Feng Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Ting Su
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian Province, PR China
| | - Lei Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - You-Lan Min
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Lai-Chang He
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
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22
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Tsai YH, Liang X, Yang JT, Hsu LM. Modular organization of brain resting state networks in patients with classical trigeminal neuralgia. NEUROIMAGE-CLINICAL 2019; 24:102027. [PMID: 31677586 PMCID: PMC6978210 DOI: 10.1016/j.nicl.2019.102027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/22/2019] [Accepted: 10/02/2019] [Indexed: 01/03/2023]
Abstract
Sensorimotor network and default mode network activities were lower in trigeminal neuralgia patients and increased after surgery. Higher communication between the default mode network module and other modules before surgery was associated with better treatment response. Subcortical modules was associated with pain duration. A lower connection between the default mode network and subcortical modules was associated with a better treatment response and the thalamus and midcingulate cortex were the major connectors within the subcortical module.
Background The modular organization of brain networks in trigeminal neuralgia patients has remained largely unknown. We aimed to analyze the brain modules and intermodule connectivity in patients with trigeminal neuralgia before and after percutaneous radiofrequency rhizotomy treatment to identify specific modules that may be associated with the development and brain plasticity of trigeminal neuralgia and to test the ability of modularity analysis to be a predictive imaging biomarker for the treatment effect in patients with trigeminal neuralgia. Methods A total of 25 patients with right trigeminal neuralgia and 20 matched healthy subjects were included. Blood-oxygen-level dependent resting state fMRI was used to analyze the brain modular organization. Results Whole brain modularity analysis identified seven modules. The metric of intermodule connectivity, participation coefficient, of the sensorimotor network and default mode network modules were significantly lower in patients and increased after surgery. The participation coefficient of the subcortical modules was associated with the pain duration. Higher communication between the default mode network module and other modules before surgery was associated with a better treatment response. Furthermore, the subcortical module was a significant contributor to the participation coefficient relationship of the default mode network module with the treatment response, and the bilateral midcingulate cortex and thalamus were major connectors in the subcortical module. Conclusions These findings have important implications regarding the global brain modular responses to chronic neuropathic pain and it may be feasible to use the modularity analysis as part of a risk stratification to predict the treatment response.
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Affiliation(s)
- Yuan-Hsiung Tsai
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Xia Liang
- Laboratory for Space Environment and Physical Sciences, Harbin Institute of Technology, Harbin 150001, China
| | - Jen-Tsung Yang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Li-Ming Hsu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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23
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Yan J, Li M, Fu S, Li G, Wang T, Yin Y, Jiang G, Lin J, Li W, Fang J, Tian J. Alterations of Dynamic Regional Homogeneity in Trigeminal Neuralgia: A Resting-State fMRI Study. Front Neurol 2019; 10:1083. [PMID: 31649618 PMCID: PMC6794683 DOI: 10.3389/fneur.2019.01083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 09/25/2019] [Indexed: 12/20/2022] Open
Abstract
Accumulating evidence from neuroimaging studies has supported that chronic pain could induce changes in brain function. However, few studies have focused on the dynamic regional homogeneity (dReHo) of trigeminal neuralgia (TN). In this study, twenty-eight TN patients and 28 healthy controls (HC) were included. Based on the resting-state fMRI (rsfMRI), we detected abnormalities in dReHo in the TN patients. Patients with TN had decreased dReHo in the left middle temporal gyrus, superior parietal lobule, and precentral gyrus, and increased dReHo in the thalamus. Furthermore, the increase in dReHo in the thalamus was positively correlated with duration of TN (r = 0.485, p = 0.012). These results provide compelling evidence for abnormal resting-state brain activity in TN and suggest that the duration of TN may play a critical role in brain function.
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Affiliation(s)
- Jianhao Yan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Meng Li
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guomin Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Tianyue Wang
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yin
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jingzhi Lin
- The Department of Neruosurgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Wuming Li
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jin Fang
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Junzhang Tian
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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Activation of the Intrinsic Pain Inhibitory Circuit from the Midcingulate Cg2 to Zona Incerta Alleviates Neuropathic Pain. J Neurosci 2019; 39:9130-9144. [PMID: 31604834 DOI: 10.1523/jneurosci.1683-19.2019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/03/2019] [Accepted: 09/22/2019] [Indexed: 12/18/2022] Open
Abstract
Neuropathic pain is one of the most common and notorious neurological diseases. The changes in cerebral structures after nerve injury and the corresponding contributions to neuropathic pain are not well understood. Here we found that the majority of glutamatergic neurons in the area 2 of midcingulate cortex (MCC Cg2Glu) were inhibited by painful stimulation in male mice. Optogenetic manipulation revealed that these neurons were tonically involved in the inhibitory modulation of multimodal nociception. We further identified the projections to GABAergic neurons in the zona incerta (ZIGABA) mediated the pain inhibitory role. However, MCC Cg2Glu became hypoactive after nerve injury. Although a brief activation of the MCC Cg2Glu to ZIGABA circuit was able to relieve the aversiveness associated with spontaneous ongoing pain, consecutive activation of the circuit was required to alleviate neuropathic allodynia. In contrast, glutamatergic neurons in the area 1 of MCC played opposite roles in pain modulation. They became hyperactive after nerve injury and only consecutive inhibition of their activity relieved allodynia. These results demonstrate that MCC Cg2Glu constitute a component of intrinsic pain inhibitory circuitry and their hypoactivity underlies neuropathic pain. We propose that selective and persistent activation of the MCC Cg2Glu to ZIGABA circuit may serve as a potential therapeutic strategy for this disease.SIGNIFICANCE STATEMENT Glutamatergic neurons in the area 2 of midcingulate cortex (MCC Cg2Glu) are tonically involved in the intrinsic pain inhibition via projecting to GABAergic neurons in the zona incerta. They are hypoactive after nerve injury. Selective activation of the circuit compensates the reduction of its analgesic strength and relieves neuropathic pain. Therefore, MCC Cg2Glu and the related analgesic circuit may serve as therapeutic targets for neuropathic pain. In contrast, MCC Cg1Glu have an opposite role in pain modulation and become hyperactive after nerve injury. The present study provides novel evidence for the concept that neuropathic pain is associated with the dysfunction of endogenous pain modulatory system and new perspective on the treatment of neuropathic pain.
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25
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Chen Y, Xiang CQ, Liu WF, Jiang N, Zhu PW, Ye L, Li B, Lin Q, Min YL, Su T, He LC, Shao Y. Application of amplitude of low‑frequency fluctuation to altered spontaneous neuronal activity in classical trigeminal neuralgia patients: A resting‑state functional MRI study. Mol Med Rep 2019; 20:1707-1715. [PMID: 31257530 PMCID: PMC6625376 DOI: 10.3892/mmr.2019.10404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/24/2019] [Indexed: 02/07/2023] Open
Abstract
Recent studies have reported structural and functional abnormalities in multiple brain regions of classical trigeminal neuralgia (CTN) patients. Differences in spontaneous neuronal activity between CTN patients and healthy subjects, however, remain unknown. The aim of the present study was to investigate alterations in brain activity by application of amplitude of low frequency fluctuation (ALFF), thus analyzing the correlation between durations of spontaneous pain intensity and ALFF values in CTN patients. A total of 28 CTN patients (male, n=12; female, n=16) and 28 healthy controls (HCs; male, n=12; female, n=16) matched for age and sex were enrolled. All subjects underwent resting‑state functional magnetic resonance imaging and changes in spontaneous brain activity were investigated using an ALFF method. Receiver operating characteristic (ROC) curve analysis was applied to differentiate ALFF values of CTN patients from HCs. Altered ALFF values and clinical manifestations were evaluated using Pearson's correlation analysis. ALFF values of the bilateral inferior cerebellum, bilateral fusiform gyrus, right precentral gyrus, left inferior temporal gyrus, right superior cerebellum, left inferior occipital gyrus and right superior occipital gyrus were significantly higher in CTN patients when compared to HCs. ROC curve analysis of each brain revealed a near‑perfect AUC accuracy. Pearson's correlation analysis revealed the visual analog scale of the right eye to be positively correlated with both left inferior temporal and occipital gyral findings, while episode duration likewise was positively associated with left inferior temporal gyral findings. CTN patients exhibited abnormal spontaneous activity in multiple brain regions closely related to pain regulation and perception, while VAS and CTN episode duration were positively correlated with ALFF signal values in some brain regions. The present findings provide further insight into the pathological mechanisms underlying CTN.
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Affiliation(s)
- You Chen
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Chu-Qi Xiang
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Wen-Feng Liu
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Nan Jiang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian 361101, P.R. China
| | - Pei-Wen Zhu
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Lei Ye
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Biao Li
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Qi Lin
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - You-Lan Min
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Ting Su
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian 361101, P.R. China
| | - Lai-Chang He
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
| | - Yi Shao
- Department of Ophthalmology and Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi 330006, P.R. China
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26
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Zhou F, Zhao Y, Zhu L, Jiang J, Huang M, Zhang Y, Zhuang Y, Gong H. Compressing the lumbar nerve root changes the frequency-associated cerebral amplitude of fluctuations in patients with low back/leg pain. Sci Rep 2019; 9:2246. [PMID: 30783132 PMCID: PMC6381144 DOI: 10.1038/s41598-019-38721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 01/08/2019] [Indexed: 12/19/2022] Open
Abstract
Understanding the central mechanisms responsible for lumbar nerve root compression may facilitate the development of new therapeutic strategies. In this study, our aim was to investigate the amplitude of fluctuations (AF) in five specific frequency bands and the full-frequency band realm to provide novel insight into the rhythm of the neuronal activity of low back/leg pain (LBLP) patients (n = 25). Compared with healthy controls, LBLP patients exhibited a significantly altered AF in multiple brain regions, including the right or left middle and inferior temporal gyri, bilateral precuneus, right anterior insula/frontal operculum, right or left inferior parietal lobule/postcentral gyrus, and other locations at five specific frequencies (P < 0.01, with Gaussian random field theory correction). Trends of an increase and a decrease in the AF in pain- and sensory-related regions, respectively, were also observed from low to high frequencies (Bonferroni-corrected α level of P < 0.05/84). In addition, in the bilateral rectal gyrus, a significant association was identified between the AF in the five specific frequency bands and disease status (P < 0.05). These findings suggest that in LBLP patients, intrinsic functional plasticity related to low back pain, leg pain and numbness affects the AF of the pain matrix and sensory-processing regions in both low- and high-frequency bands.
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Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China. .,Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China.
| | - Yanlin Zhao
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China.,Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Li Zhu
- School of Information Engineering, Nanchang University, Nanchang, 330031, People's Republic of China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China.,Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China.,Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
| | - Yong Zhang
- Department of Pain Clinic, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China.
| | - Ying Zhuang
- Department of Oncology, The Second Hospital of Nanchang, Nanchang, 330003, People's Republic of China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China.,Neuroimaging Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China
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27
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Ayoub LJ, Seminowicz DA, Moayedi M. A meta-analytic study of experimental and chronic orofacial pain excluding headache disorders. NEUROIMAGE-CLINICAL 2018; 20:901-912. [PMID: 30292089 PMCID: PMC6176551 DOI: 10.1016/j.nicl.2018.09.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 01/08/2023]
Abstract
Chronic orofacial pain (COFP) disorders are prevalent and debilitating pain conditions affecting the head, neck and face areas. Neuroimaging studies have reported functional and grey matter abnormalities, but not all the studies have reported consistent findings. Identifying convergent abnormalities across COFPs provides a basis for future hypothesis-driven research aimed at elucidating common CNS mechanisms. Here, we perform three coordinate-based meta-analyses according to PRISMA guidelines to elucidate the central mechanisms of orofacial pain disorders. Specifically, we investigated consistent patterns of: (1) brain function to experimental orofacial pain in healthy subjects, (2) structural and (3) functional brain abnormalities in COFP. We computed our coordinate-based meta-analyses using GingerALE. The experimental pain meta-analysis revealed increased brain activity in bilateral thalami, posterior mid-cingulate cortices, and secondary somatosensory cortices, the right posterior parietal cortex extending to the orofacial region of the right primary somatosensory cortex and the right insula, and decreased activity in the right somatomotor regions. The structural COFP meta-analysis identified consistent higher grey matter volume/concentration in the right ventral thalamus and posterior putamen of COFP patients compared to healthy controls. The functional COFP meta-analysis identified a consistent increase in brain activity in the left medial and posterior thalamus and lesser activity in the left posterior insula in COFP, compared to healthy controls. Overall, these findings provide evidence of brain abnormalities in pain-related regions, namely the thalamus and insula, across different COFP disorders. The convergence of thalamic abnormalities in both structure and function suggest a key role for this region in COFP pathophysiology. Identifying convergent abnormalities in COFP can elucidate novel therapeutic targets. Experimental orofacial pain is associated with activity in nociceptive processing brain areas. Chronic orofacial pain (COFP) is associated with abnormal thalamic activity and grey matter. Our review highlights the need for more high quality COFP brain imaging studies.
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Affiliation(s)
- Lizbeth J Ayoub
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada
| | - David A Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, United States; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
| | - Massieh Moayedi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada.
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