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. 2018 Jul;34(7):600-609.
doi: 10.1097/AJP.0000000000000578.

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia: A Resting-state Functional MRI Study

Jie Yuan  1   2 , Song Cao  2 , Yue Huang  1 , Yi Zhang  2 , Peng Xie  3 , Yu Zhang  3 , Bao Fu  3 , Tijiang Zhang  4 , Ganjun Song  4 , Tian Yu  3 , Mazhong Zhang  1
Affiliations

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia: A Resting-state Functional MRI Study

Jie Yuan et al. Clin J Pain. 2018 Jul.

Abstract

Objectives: To identify the changes of local coherence and intrinsic brain activity in resting-state idiopathic trigeminal neuralgia (ITN) patients by using regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) analysis.

Methods: ReHo and fALFF were analyzed in 23 ITN patients and 23 age-matched and sex-matched pain-free controls to detect the functional abnormality in the brains of ITN patients. Correlations between ReHo and fALFF were analyses. ITN pain intensity were also assessed in the ITN group.

Results: Compared with pain-free controls, ITN patients exhibited significantly abnormal ReHo and fALFF in several brain regions, including the cerebellum, cingulate cortex, temporal lobe, putamen, occipital lobe, limbic lobe, precuneus, insula, medial, and superior frontal gyrus compared with healthy controls. Correlation analysis showed that ReHo values of several altered brain areas positively correlated with visual analog scale values. But no correlation was found between fALFF and visual analog scale.

Discussion: Our results showed that ITN patients exhibited significantly abnormal spontaneous brain activity in several brain regions that are involved in pain modulation and perception. The present study reflects the maladaptive process of daily pain attacks and may enhance the understanding of how chronic pain affects local intrinsic brain activity.

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Conflict of interest statement

Supported by the Shanghai Municipal Commission of Health and Family Planning, Key Developing Disciplines (grant no. 2015ZB0106), Shanghai, Chian, Pudong New District Science and Technology Development Innovation Foundation, Shanghai, China (grant no. PKJ 2013-Y61). The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Clusters showing ReHo differences between ITN patients and pain-free controls in axial (A) and sagittal (B) slices. The cold colors indicate lower ReHo in ITN patients than healthy control group, whereas the warm colors mean vice versa (P<0.05, AlphaSim corrected). Brain images are displayed in radiology convention (eg, the left in the figure represents the right side of patients’ brains and vice versa). ITN indicates idiopathic trigeminal neuralgia; ReHo, regional homogeneity.
FIGURE 2
FIGURE 2
Clusters showing fALFF differences between ITN patients and pain-free controls in axial (A) and sagittal (B) slices. The cold colors indicate lower fALFF in ITN patients than pain-free control group, whereas the warm colors mean vice versa (P<0.05, AlphaSim corrected). Brain images are displayed in radiology convention (eg, the left in the figure represents the right side of patients’ brains and vice versa). fALFF indicates fractional amplitude of low-frequency fluctuation; ITN, idiopathic trigeminal neuralgia.
FIGURE 3
FIGURE 3
VAS value and ReHo correlation. Brain regions with colors showed significant correlation between ITN patients and pain-free controls. Their distribution is displayed in axial (A) and sagittal (B) way. The warm colors indicate higher positive correlation, whereas cool colors indicate negative correlation (P<0.05, corrected). Brain images are displayed in radiology convention (eg, the left in the figure represents the right side of patients’ brains and vice versa). ITN indicates idiopathic trigeminal neuralgia; ReHo, regional homogeneity; VAS, visual analog scale.
FIGURE 4
FIGURE 4
Correlation between VAS score and the ReHo values in CPL, MTG, ACC, precuneus, MFG, SFG as well as insula in the ITN patients. A, The ReHo value in CPL is positively correlates with vas in the ITN patients (r2=0.536, P<0.0001). B, The ReHo value in MTG is positively correlates with VAS in the ITN patients (r2=0.4671, P=0.0003). C, The ReHo value in ACC is inversely correlates with VAS in the ITN patients (r2=−0.4671, P=0.0003). D, The ReHo value in precuneus is inversely correlates with VAS in the ITN patients (r2=−0.4838, P=0.0002). E, The ReHo value in MFG is inversely correlates with VAS in the ITN patients (r2=−0.5213, P=0.0001). F, The ReHo value in SFG is inversely correlates with VAS in the ITN patients (r2=−0.5175, P=0.0001). G, The ReHo value in insula is inversely correlates with VAS in the ITN patients (r2=−0.2824, P=0.0091). ACC indicates anterior cingulate cortex; CPL, cerebellum posterior lobe; ITN, idiopathic trigeminal neuralgia; L, left; MFG, medial frontal gyrus; MTG, middle temporal gyrus; R, right; ReHo, regional homogeneity; SFG, superior frontal gyrus; VAS, visual analog scale.
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