Cerebral perfusion alterations in patients with trigeminal neuralgia as measured by pseudo-continuous arterial spin labeling

Qianling Zhou; Meng Li; Qisen Fan; Feng Chen; Guihua Jiang; Tianyue Wang; Qinmeng He; Shishun Fu; Yi Yin; Jinzhi Lin; Jianhao Yan

doi:10.3389/fnins.2022.1065411

Cerebral perfusion alterations in patients with trigeminal neuralgia as measured by pseudo-continuous arterial spin labeling

Front Neurosci. 2022 Dec 16:16:1065411. doi: 10.3389/fnins.2022.1065411. eCollection 2022.

Authors

Qianling Zhou^{1

2}, Meng Li², Qisen Fan³, Feng Chen², Guihua Jiang², Tianyue Wang², Qinmeng He², Shishun Fu², Yi Yin², Jinzhi Lin⁴, Jianhao Yan^{2

1}

Affiliations

¹ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
² Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.
³ Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁴ Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, China.

Abstract

Background: Accumulating evidence suggests that trigeminal neuralgia (TN) causes structural and functional alterations in the brain. However, only a few studies have focused on cerebral blood flow (CBF) changes in patients with TN. This study aimed to explore whether altered cerebral perfusion patterns exist in patients with TN and investigate the relationship between abnormal regional CBF (rCBF) and clinical characteristics of TN.

Materials and methods: This study included 28 patients with TN and 30 age- and sex-matched healthy controls (HCs) who underwent perfusion functional MRI (fMRI) of the brain using pseudo-continuous arterial spin labeling (pCASL) in the resting state. The regions of significantly altered CBF in patients with TN were detected using group comparison analyses. Then, the relationships between the clinical characteristics and abnormal rCBF were further investigated.

Results: Compared to the control group, patients with TN exhibited increased rCBF, primarily in the thalamus, middle frontal gyrus (MFG), and left insula. Furthermore, the CBF values of the thalamus were negatively correlated with the pain intensity of TN and positively correlated with pain duration in patients with TN.

Conclusion: Primary alterations in rCBF in patients with TN occurred in different brain regions related to pain, which are involved in cognitive-affective interaction, pain perception, and pain modulation. These results indicate that non-invasive resting cerebral perfusion imaging may contribute complementary information to further understanding the neuropathological mechanism underlying TN.

Keywords: arterial spin labeling; brain; cerebral blood flow; chronic pain; functional MRI; trigeminal neuralgia.