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. 2023 Mar 22:17:1112662.
doi: 10.3389/fnana.2023.1112662. eCollection 2023.

A preliminary study of diffusion tensor imaging in root entry zone of primary trigeminal neuralgia

Yiwen Wang  1   2   3   4   5 , Danni Wang  6 , Yingwei Wu  7 , Ce Zhu  2   3   4   5   8 , Wenbin Wei  1   2   3   4   5 , Yao Li  6 , Lingzhi Li  9 , Wantao Chen  2   3   4   5   10 , Minjie Chen  1   2   3   4   5
Affiliations

A preliminary study of diffusion tensor imaging in root entry zone of primary trigeminal neuralgia

Yiwen Wang et al. Front Neuroanat. .

Abstract

Objective: Primary Trigeminal Neuralgia (PTN) is a common and refractory neurological disease. Conventional vascular compression theory could not completely explain the etiology and pathogenesis of PTN. This study used diffusion tensor imaging (DTI) to demonstrate the microstructural changes of root entry zone (REZ) region in PTN patients.

Materials and methods: DTI sequences was performed on PTN patients and healthy controls (HCs). Clinical data included affected side, disease course and visual analogue scale (VAS) were collected. Quantitative DTI variables such as FA, MD, AD and RD of the root entry/Exit zone (REZ) were measured and compared in PTN/HCs, affected/unaffected side, and pre/post operation groups. The PCoA was established to conduct overall differences between PTN group and the HCs.

Results: A total of 17 patients with PTN (mean age 59.29 ± 8.53; 5 men) and 34 HCs (mean age 57.70 ± 6.37; 10 men) were included. Lower FA value of the affected side of PTN group was observed compared to the unaffected side and the HCs (p = 0.001), whereas the values of MD, AD and RD were significantly increased (p < 0.001). Moreover, the decrease of FA value was recovered post operation. PCoA results of the comprehensive indexes can significantly distinguish PTN group from HCs (r = 0.500, p < 0.001).

Conclusion: Quantitative variables derived from DTI in REZ had significantly different profiles between PTN patients and HCs, which were associated with VAS situation and the disease course of PTN. The comprehensive index established on DTI variables were of great potential to reveal the microstructure changes in PTN patients and predict the therapeutic effect.

Keywords: diffusion tensor imaging; magnetic resonance imaging; neurovascular compression (NVC); primary trigeminal neuralgia; root entry zone.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The path of trigeminal nerve fiber bundles was reconstructed on the generated color direction map, and ROI points were depicted (arrow indicated) in REZ. FA, RD, AD, and MD values of trigeminal nerve corresponding to ROI points in each REZ region were measured. (A) Horizontal position; (B) coronal position; and (C) sagittal position.
FIGURE 2
FIGURE 2
Difference analysis of FA, MD, AD, and RD values in REZ among TN_affected side, TN_unaffected side, and HC groups. *p < 0.05.
FIGURE 3
FIGURE 3
Correlation between FA, MD, AD, and RD of PTN patients and their disease course and VAS.
FIGURE 4
FIGURE 4
Principal coordinates analysis (PCoA) of the affected side (TN_affected), unaffected side (TN_unaffected) in the PTN group and HC group showed significant differences in the four DTI indicators between TN_affected and HC groups (r = 0.500, p < 0.001) and TN_affected and TN_unffected groups (r = 0.412, p < 0.001), but no significant differences between TN_unaffected and HC groups (r = –0.016, p = 0.220).
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