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Li H, Lu Y, Xie W, Ye J, Wang Q, Zhang Z, Jiang Y, Li Z. Altered structure and functional connection of subcortical gray matter in female patients with classical trigeminal neuralgia. Brain Imaging Behav 2024:10.1007/s11682-024-00943-1. [PMID: 39340625 DOI: 10.1007/s11682-024-00943-1] [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] [Accepted: 09/19/2024] [Indexed: 09/30/2024]
Abstract
The etiology of classical trigeminal neuralgia (CTN) is still unclear. A better understanding of the cerebral structural and functional changes in female patients with CTN may provide important novel insights into the pathophysiologic mechanisms of female CTN. A total 37 female CTN patients were included and referred to MRI scans, comprising with 19 left CTN and 18 right CTN patients. We analyzed the volume and shape of subcortical gray matter (GM), and the functional connectivity (FC) between the accumbens nucleus (NAc) and whole brain in right and left CTN patients respectively. We found left CTN patients had a reduced right NAc volume compared to controls, similarly, the right CTN had the decreased volume in the left NAc. Vertex-wise shapes of right NAc in left CTN patients showed significant regional shape deformation on the anterior, medial and ventroposterior aspects, in contrast, left NAc of right CTN patients showed significant regional shape deformation on the anterior and posterior aspect. Furthermore, patients with left CTN showed significantly lower FC between the right NAc and right orbitofrontal cortex than control subjects. The volume of NAc in all CTN was significantly related to the perception of present pain intensity. The CTN might be majorly caused by volume reduction in NAc. A greater understanding of the neurobiological basis of pain-related changes in NAc will provide the knowledge for the development of novel NAc based therapeutic targets for pain management or even prevention in CTN patients.
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Affiliation(s)
- Huiru Li
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yi Lu
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Wei Xie
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Junjie Ye
- Yunnan Population and Family Planning Institute, Kunming, Yunnan, China
| | - Qing Wang
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Zhenguang Zhang
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuanming Jiang
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Zongfang Li
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
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Yan J, Wang L, Pan L, Ye H, Zhu X, Feng Q, Ding Z, Ge X, Shi L. Analyzing the risk factors of unilateral trigeminal neuralgia under neurovascular compression. Front Hum Neurosci 2024; 18:1349186. [PMID: 38699563 PMCID: PMC11064654 DOI: 10.3389/fnhum.2024.1349186] [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: 12/04/2023] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Background This study aimed to explore the risk factors and potential causes of unilateral classical or idiopathic trigeminal neuralgia (C-ITN) by comparing patients and healthy controls (HCs) with neurovascular compression (NVC) using machine learning (ML). Methods A total of 84 C-ITN patients and 78 age- and sex-matched HCs were enrolled. We assessed the trigeminal pons angle and identified the compressing vessels and their location and severity. Machine learning was employed to analyze the cisternal segment of the trigeminal nerve (CN V). Results Among the C-ITN patients, 53 had NVC on the unaffected side, while 25 HCs exhibited bilateral NVC, and 24 HCs showed unilateral NVC. By comparing the cisternal segment of CN V between C-ITN patients on the affected side and HCs with NVC, we identified the side of NVC, the compressing vessel, and certain texture features as risk factors for C-ITN. Additionally, four texture features differed in the structure of the cisternal segment of CN V between C-ITN patients on the unaffected side and HCs with NVC. Conclusion Our findings suggest that the side of NVC, the compressing vessel, and the microstructure of the cisternal segment of CN V are associated with the risk of C-ITN. Furthermore, microstructural changes observed in the cisternal segment of CN V on the unaffected side of C-ITN patients with NVC indicate possible indirect effects on the CN V to some extent.
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Affiliation(s)
- Juncheng Yan
- Department of Rehabilitation, Hangzhou First People's Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Lei Pan
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Haiqi Ye
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xiaofen Zhu
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Lei Shi
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Hangzhou, China
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Hastreiter P, Maliachova O, Fahlbusch R, Doerfler A, Buchfelder M, Naraghi R. Comparing 1.5 T and 3.0 T MR data for 3D visualization of neurovascular relationships in the posterior fossa. Acta Neurochir (Wien) 2023; 165:3853-3866. [PMID: 37999915 PMCID: PMC10739234 DOI: 10.1007/s00701-023-05878-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: 06/19/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Neurovascular relationships in the posterior fossa are more frequently investigated due to the increasing availability of 3.0 Tesla MRI. For an assessment with 3D visualization, no systematic analyzes are available so far and the question arises as to whether 3.0 Tesla MRI should be given preference over 1.5 Tesla MRI. METHODS In a prospective study, a series of 25 patients each underwent MRI investigations with 3D-CISS and 3D-TOF at 1.5 and 3.0 Tesla. For both field strengths separately, blood vessel information from the TOF data was fused into the CISS data after segmentation and registration. Four visualizations were created for each field strength, with and without optimization before and after fusion, which were evaluated with a rating system and verified with the intraoperative situation. RESULTS When only CISS data was used, nerves and vessels were better visualized at 1.5 Tesla. After fusion, flow and pulsation artifacts were reduced in both cases, missing vessel sections were supplemented at 3.0 Tesla and 3D visualization at 1.5 and 3.0 Tesla led to anatomically comparable results. By subsequent manual correction, the remaining artifacts were further eliminated, with the 3D visualization being significantly better at 3.0 Tesla, since the higher field strength led to sharper contours of small vessel and nerve structures. CONCLUSION 3D visualizations at 1.5 Tesla are sufficiently detailed for planning microvascular decompression and can be used without restriction. Fusion further improves the quality of 3D visualization at 3.0 Tesla and enables an even more accurate delineation of cranial nerves and vessels.
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Affiliation(s)
- Peter Hastreiter
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Olga Maliachova
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
- Pediatric Department, Triemli Hospital, Zurich, Switzerland
| | - Rudolf Fahlbusch
- Clinic for Endocrine Neurosurgery, International Neuroscience Institute, Hanover, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Ramin Naraghi
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
- Department of Neurosurgery, German Federal Armed Forces Central Hospital Koblenz, Koblenz, Germany
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Westwood SJ, Conti AA, Tang W, Xue S, Cortese S, Rubia K. Clinical and cognitive effects of external trigeminal nerve stimulation (eTNS) in neurological and psychiatric disorders: a systematic review and meta-analysis. Mol Psychiatry 2023; 28:4025-4043. [PMID: 37674019 PMCID: PMC10827664 DOI: 10.1038/s41380-023-02227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
This pre-registered (CRD42022322038) systematic review and meta-analysis investigated clinical and cognitive outcomes of external trigeminal nerve stimulation (eTNS) in neurological and psychiatric disorders. PubMed, OVID, Web of Science, Chinese National Knowledge Infrastructure, Wanfang, and VIP database for Chinese technical periodicals were searched (until 16/03/2022) to identify trials investigating cognitive and clinical outcomes of eTNS in neurological or psychiatric disorders. The Cochrane Risk of Bias 2.0 tool assessed randomized controlled trials (RCTs), while the Risk of Bias of Non-Randomized Studies (ROBINS-I) assessed single-arm trials. Fifty-five peer-reviewed articles based on 48 (27 RCTs; 21 single-arm) trials were included, of which 12 trials were meta-analyzed (N participants = 1048; of which ~3% ADHD, ~3% Epilepsy, ~94% Migraine; age range: 10-49 years). The meta-analyses showed that migraine pain intensity (K trials = 4, N = 485; SMD = 1.03, 95% CI[0.84-1.23]) and quality of life (K = 2, N = 304; SMD = 1.88, 95% CI[1.22-2.53]) significantly improved with eTNS combined with anti-migraine medication. Dimensional measures of depression improved with eTNS across 3 different disorders (K = 3, N = 111; SMD = 0.45, 95% CI[0.01-0.88]). eTNS was well-tolerated, with a good adverse event profile across disorders. eTNS is potentially clinically relevant in other disorders, but well-blinded, adequately powered RCTs must replicate findings and support optimal dosage guidance.
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Affiliation(s)
- Samuel J Westwood
- Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK.
- Department of Psychology, School of Social Science, University of Westminster, London, UK.
| | - Aldo Alberto Conti
- Department of Child and Adolescent Psychiatry; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Wanjie Tang
- Department of Child and Adolescent Psychiatry; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child & Adolescent Psychiatry, Technical University Dresden, Dresden, Germany
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Kirstein CF, Güntürkün O, Ocklenburg S. Ultra-high field imaging of the amygdala - A narrative review. Neurosci Biobehav Rev 2023; 152:105245. [PMID: 37230235 DOI: 10.1016/j.neubiorev.2023.105245] [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: 01/30/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 05/27/2023]
Abstract
The amygdala is an evolutionarily conserved core structure in emotion processing and one of the key regions of interest in affective neuroscience. Results of neuroimaging studies focusing on the amygdala are, however, often heterogeneous since it is composed of functionally and neuroanatomically distinct subnuclei. Fortunately, ultra-high-field imaging offers several advances for amygdala research, most importantly more accurate representation of functional and structural properties of subnuclei and their connectivity. Most clinical studies using ultra-high-field imaging focused on major depression, suggesting either overall rightward amygdala atrophy or distinct bilateral patterns of subnuclear atrophy and hypertrophy. Other pathologies are only sparsely covered. Connectivity analyses identified widespread networks for learning and memory, stimulus processing, cognition, and social processes. They provide evidence for distinct roles of the central, basal, and basolateral nucleus, and the extended amygdala in fear and emotion processing. Amid largely sparse and ambiguous evidence, we propose theoretical and methodological considerations that will guide ultra-high-field imaging in comprehensive investigations to help disentangle the ambiguity of the amygdala's function, structure, connectivity, and clinical relevance.
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Affiliation(s)
- Cedric Fabian Kirstein
- Department of Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Germany.
| | - Onur Güntürkün
- Department of Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Germany; Research Center One Health Ruhr, Research Alliance Ruhr, Ruhr-University Bochum, Bochum, Germany
| | - Sebastian Ocklenburg
- Department of Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Germany; Department of Psychology, MSH Medical School Hamburg, Germany; Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Germany
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Ge X, Wang L, Pan L, Ye H, Zhu X, Fan S, Feng Q, Du Q, Yu W, Ding Z. Alteration of the cortical morphology in classical trigeminal neuralgia: voxel-, deformation-, and surface-based analysis. J Headache Pain 2023; 24:17. [PMID: 36809919 PMCID: PMC9942396 DOI: 10.1186/s10194-023-01544-x] [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: 01/07/2023] [Accepted: 02/02/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE This study aimed to combine voxel-based morphometry, deformation-based morphometry, and surface-based morphometry to analyze gray matter volume and cortex shape in classical trigeminal neuralgia patients. METHODS This study included 79 classical trigeminal neuralgia patients and age- and sex-matched 81 healthy controls. The aforementioned three methods were used to analyze brain structure in classical trigeminal neuralgia patients. Spearman correlation analysis was used to analyze the correlation of brain structure with the trigeminal nerve and clinical parameters. RESULTS The bilateral trigeminal nerve was atrophied, and the ipsilateral trigeminal nerve volume was smaller than the contralateral volume in the classical trigeminal neuralgia. The gray matter volume of Temporal_Pole_Sup_R and Precentral_R was found to be decreased using voxel-based morphometry. The gray matter volume of Temporal_Pole_Sup_R had a positive correlation with disease duration and a negative correlation with the cross-section area of the compression point and the quality-of-life score in trigeminal neuralgia. The gray matter volume of Precentral_R was negatively correlated with the ipsilateral volume of the trigeminal nerve cisternal segment, cross-section area of compression point, and visual analogue scale. The gray matter volume of Temporal_Pole_Sup_L was found to be increased using deformation-based morphometry and had a negative correlation with the self-rating anxiety scale. The gyrification of the middle temporal gyrus_L increased and the Postcentral_L thickness decreased, as detected using surface-based morphometry. CONCLUSIONS The gray matter volume and cortical morphology of pain-related brain regions were correlated with clinical and trigeminal nerve parameters. voxel-based morphometry, deformation-based morphometry, and surface-based morphometry complemented each other in analyzing the brain structures of patients with classical trigeminal neuralgia and provided a basis for studying the pathophysiology of classical trigeminal neuralgia.
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Affiliation(s)
- Xiuhong Ge
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China ,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineShangcheng District, No.261, Huansha RoadZhejiang Province, Hangzhou, 310006 China
| | - Luoyu Wang
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China ,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineShangcheng District, No.261, Huansha RoadZhejiang Province, Hangzhou, 310006 China
| | - Lei Pan
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China
| | - Haiqi Ye
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China
| | - Xiaofen Zhu
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China
| | - Sandra Fan
- grid.268505.c0000 0000 8744 8924Zhejiang Chinese Medical University, Hangzhou, China
| | - Qi Feng
- grid.13402.340000 0004 1759 700XDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000 People’s Republic of China
| | - Quan Du
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China.
| | - Wenhua Yu
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China.
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China. .,Department of Radiology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Cancer Center, Affiliated Hangzhou First People's HospitalZhejiang University School of MedicineShangcheng District, No.261, Huansha RoadZhejiang Province, Hangzhou, 310006, China.
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Lee MJ, Al-Karagholi MAM, Reuter U. New migraine prophylactic drugs: Current evidence and practical suggestions for non-responders to prior therapy. Cephalalgia 2023; 43:3331024221146315. [PMID: 36759320 DOI: 10.1177/03331024221146315] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Monoclonal antibodies against calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP(-R) mAbs) and small-molecule CGRP receptor antagonists (gepants) are new mechanism-based prophylactic drugs developed to address the unmet needs of pre-existing migraine prophylactic medications. However, several uncertainties remain in their real-world applications. METHODS This is a narrative review of the literature on the use of CGRP-targeting novel therapeutics in specific situations, including non-responders to prior therapy, combination therapy, switching, and treatment termination. In the case of lack of available literature, we made suggestions based on clinical reasoning. RESULTS High-quality evidence supports the use of all available anti-CGRP(-R) mAbs (erenumab, galcanezumab, fremanezumab, and eptinezumab) in non-responders to prior therapy. There is insufficient evidence to support or reject the efficacy of combining CGRP(-R) mAbs or gepants with oral migraine prophylactic agents or botulinum toxin A. Switching from one CGRP(-R) mAb to another might benefit a fraction of patients. Currently, treatment termination depends on reimbursement policies, and the optimal mode of termination is discussed. CONCLUSIONS New prophylactic drugs that target the CGRP pathway are promising treatment options for patients with difficult-to-treat migraine. Individualized approaches using a combination of new substances with oral prophylactic drugs or botulinum toxin A, switching between new drugs, and adjusting treatment duration could enhance excellence in practice.
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Affiliation(s)
- Mi Ji Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Mohammad Al-Mahdi Al-Karagholi
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Greifswald, Germany.,Board of Directors, Universitätsmedizin Greifswald, Greifswald, Germany
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Zhang P, Wan X, Ai K, Zheng W, Liu G, Wang J, Huang W, Fan F, Yao Z, Zhang J. Rich-club reorganization and related network disruptions are associated with the symptoms and severity in classic trigeminal neuralgia patients. Neuroimage Clin 2022; 36:103160. [PMID: 36037660 PMCID: PMC9434131 DOI: 10.1016/j.nicl.2022.103160] [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: 03/24/2022] [Revised: 07/20/2022] [Accepted: 08/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alterations in white matter microstructure and functional activity have been demonstrated to be involved in the central nervous system mechanism of classic trigeminal neuralgia (CTN). However, the rich-club organization and related topological alterations in the CTN brain networks remain unclear. METHODS We simultaneously collected diffusion-tensor imaging (DTI) and resting state functional magnetic resonance imaging (rs-fMRI) data from 29 patients with CTN (9 males, mean age = 54.59 years) and 34 matched healthy controls (HCs) (12 males, mean age = 54.97 years) to construct structural networks (SNs) and functional networks (FNs). Rich-club organization was determined separately based on each group's SN and different kinds of connections. For both network types, we calculated the basic connectivity properties (network density and strength) and topological properties (global/local/nodal efficiency and small worldness). Moreover, SN-FN coupling was obtained. The relationships between all those properties and clinical measures were evaluated. RESULTS Compared to their FN, the SN of CTN patients was disrupted more severely, including its topological properties (reduced network efficiency and small-worldness), and a decrease in network density and strength was observed. Patients showed reorganization of the rich-club architecture, wherein the nodes with decreased nodal efficiency in the SN were mainly non-hub regions, and the local connections were closely related to altered global efficiency and whole brain coupling. While the cortical-subcortical connections of feeder were found to be strengthened in the SN of patients, the coupling between networks increased in all types of connections. Finally, disease severity (duration, pain intensity, and affective alterations) was negatively correlated with coupling (rich-club, feeder, and whole brain) and network strength (the rich-club of the SN and local connections of the FN). A positive correlation was only found between pain intensity and the coupling of local connections. CONCLUSIONS The SN of patients with CTN may be more vulnerable. Accompanied by the reorganization of the rich-club, the less efficient network communication and the impaired functional dynamics were largely attributable to the dysfunction of non-hub regions. As compensation, the pain transmission pathway of feeder connections involving in pain processing and emotional regulation may strengthen. The local and feeder sub-networks may serve as potential biomarkers for diagnosis or prognosis.
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Affiliation(s)
- Pengfei Zhang
- Second Clinical School, Lanzhou University, Lanzhou 730000, China,Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Xinyue Wan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Kai Ai
- Philips, Healthcare, Xi’an 710000, China
| | - Weihao Zheng
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Guangyao Liu
- Second Clinical School, Lanzhou University, Lanzhou 730000, China,Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Jun Wang
- Second Clinical School, Lanzhou University, Lanzhou 730000, China,Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Wenjing Huang
- Second Clinical School, Lanzhou University, Lanzhou 730000, China,Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Fengxian Fan
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China,Corresponding authors at: Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, No. 222 South Tianshui Road, Lanzhou 730000, China (Z. Yao). Department of Magnetic Resonance, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, China (J. Zhang).
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China,Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China,Corresponding authors at: Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, No. 222 South Tianshui Road, Lanzhou 730000, China (Z. Yao). Department of Magnetic Resonance, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, China (J. Zhang).
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Maltsev D, Fedirko V. Refractory atypical trigeminal neuralgia associated with reactivated herpesvirus infection: pathogenetic link and efficacy of combination antiviral therapy. Virusdisease 2022; 33:155-165. [DOI: 10.1007/s13337-022-00769-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022] Open
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Ge X, Wang L, Pan L, Ye H, Zhu X, Feng Q, Ding Z. Risk Factors for Unilateral Trigeminal Neuralgia Based on Machine Learning. Front Neurol 2022; 13:862973. [PMID: 35463121 PMCID: PMC9024101 DOI: 10.3389/fneur.2022.862973] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 01/01/2023] Open
Abstract
Purpose Neurovascular compression (NVC) is considered as the main factor leading to the classical trigeminal neuralgia (CTN), and a part of idiopathic TN (ITN) may be caused by NVC (ITN-nvc). This study aimed to explore the risk factors for unilateral CTN or ITN-nvc (UC-ITN), which have bilateral NVC, using machine learning (ML). Methods A total of 89 patients with UC-ITN were recruited prospectively. According to whether there was NVC on the unaffected side, patients with UC-ITN were divided into two groups. All patients underwent a magnetic resonance imaging (MRI) scan. The bilateral cisternal segment of the trigeminal nerve was manually delineated, which avoided the offending vessel (Ofv), and the features were extracted. Dimensionality reduction, feature selection, model construction, and model evaluation were performed step-by-step. Results Four textural features with greater weight were selected in patients with UC-ITN without NVC on the unaffected side. For UC-ITN patients with NVC on the unaffected side, six textural features with greater weight were selected. The textural features (rad_score) showed significant differences between the affected and unaffected sides (p < 0.05). The nomogram model had optimal diagnostic power, and the area under the curve (AUC) in the training and validation cohorts was 0.76 and 0.77, respectively. The Ofv and rad_score were the risk factors for UC-ITN according to nomogram. Conclusion Besides NVC, the texture features of trigeminal-nerve cisternal segment and Ofv were also the risk factors for UC-ITN. These findings provided a basis for further exploration of the microscopic etiology of UC-ITN.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Lei Pan
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiqi Ye
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaofen Zhu
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 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, China
- *Correspondence: Zhongxiang Ding orcid.org/0000-0001-7691-5571
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