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

Yiwen Wang; Danni Wang; Yingwei Wu; Ce Zhu; Wenbin Wei; Yao Li; Lingzhi Li; Wantao Chen; Minjie Chen

doi:10.3389/fnana.2023.1112662

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

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

Authors

Yiwen Wang^{1

2

3

4

5}, Danni Wang⁶, Yingwei Wu⁷, Ce Zhu^{2

3

4

5

8}, Wenbin Wei^{1

2

3

4

5}, Yao Li⁶, Lingzhi Li⁹, Wantao Chen^{2

3

4

5

10}, Minjie Chen^{1

2

3

4

5}

Affiliations

¹ Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
³ National Center for Stomatology, Shanghai, China.
⁴ National Clinical Research Center for Oral Diseases, Shanghai, China.
⁵ Shanghai Key Laboratory of Stomatology, Shanghai, China.
⁶ School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
⁷ Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁸ Department of Preventive Dentistry, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁹ Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China.
¹⁰ Department of Oral and Maxillofacial-Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

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.

Grants and funding

This study was supported by the Innovative Research Team of High-level Local Universities in Shanghai (SHSMU-ZLCX20212301), the Key Biological and Pharmaceutical Projects of Shanghai Science and Technology Commission (Grant No. 16411953300), the Clinical Research MDT Project of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University (Grant No. 201701018), the Science and Technology Commission of Shanghai Municipality (Grant No. 21Y11903500), National Natural Science Foundation of China (81472515), National Key Research and Development Program (2016YFC0902700), Shanghai Science and Technology of Committee (21DZ2292000 and 23140902600), and SJTU Trans-med Awards Research (WF540162615).