Amplitude of low-frequency fluctuation after a single-trigger pain in patients with classical trigeminal neuralgia

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Abstract

Objective

This study aimed to explore the central mechanism of classical trigeminal neuralgia (CTN) by analyzing the static amplitude of low-frequency fluctuation (sALFF) and dynamic amplitude of low-frequency fluctuation (dALFF) in patients with CTN before and after a single-trigger pain.

Methods

This study included 48 patients (37 women and 11 men, age 55.65 ± 11.41 years) with CTN. All participants underwent 3D-T1WI and three times resting-state functional magnetic resonance imaging. The images were taken before stimulating the trigger zone (baseline), within 5 s after stimulating the trigger zone (triggering-5 s), and in the 30th minute after stimulating the trigger zone (triggering-30 min). The differences between the three measurements were analyzed using a repeated-measures analysis of variance.

Results

The sALFF values of the bilateral middle occipital gyrus and right cuneus gradually increased, and the values of the left posterior cingulum gyrus and bilateral superior frontal gyrus gradually decreased in triggering-5 s and triggering-30 min. The values of the right middle temporal gyrus and right thalamus decreased in triggering-5 s and subsequently increased in triggering-30 min. The sALFF values of the left superior temporal gyrus increased in triggering-5 s and then decreased in triggering-30 min. The dALFF values of the right fusiform gyrus, bilateral lingual gyrus, left middle temporal gyrus, and right cuneus gyrus gradually increased in both triggering-5 s and triggering-30 min.

Conclusions

The sALFF and dALFF values changed differently in multiple brain regions in triggering-5 s and triggering-30 min of CTN patients after a single trigger of pain, and dALFF is complementary to sALFF. The results might help explore the therapeutic targets for relieving pain and improving the quality of life of patients with CTN.

Supplementary Information

The online version contains supplementary material available at 10.1186/s10194-022-01488-8.

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Most cited references 46

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Subregions of the human superior frontal gyrus and their connections.

Wei Li, Wen Qin, Huaigui Liu … (2013)

The superior frontal gyrus (SFG) is located at the superior part of the prefrontal cortex and is involved in a variety of functions, suggesting the existence of functional subregions. However, parcellation schemes of the human SFG and the connection patterns of each subregion remain unclear. We firstly parcellated the human SFG into the anteromedial (SFGam), dorsolateral (SFGdl), and posterior (SFGp) subregions based on diffusion tensor tractography. The SFGam was anatomically connected with the anterior and mid-cingulate cortices, which are critical nodes of the cognitive control network and the default mode network (DMN). The SFGdl was connected with the middle and inferior frontal gyri, which are involved in the cognitive execution network. The SFGp was connected with the precentral gyrus, caudate, thalamus, and frontal operculum, which are nodes of the motor control network. Resting-state functional connectivity analysis further revealed that the SFGam was mainly correlated with the cognitive control network and the DMN; the SFGdl was correlated with the cognitive execution network and the DMN; and the SFGp was correlated with the sensorimotor-related brain regions. The SFGam and SFGdl were further parcellated into three and two subclusters that are well corresponding to Brodmann areas. These findings suggest that the human SFG consists of multiple dissociable subregions that have distinct connection patterns and that these subregions are involved in different functional networks and serve different functions. These results may improve our understanding on the functional complexity of the SFG and provide us an approach to investigate the SFG at the subregional level. Copyright © 2013 Elsevier Inc. All rights reserved.

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European Academy of Neurology guideline on trigeminal neuralgia

L Bendtsen, J. Zakrzewska, J. Abbott … (2018)

Trigeminal neuralgia (TN) is an extremely painful condition which can be difficult to diagnose and treat. In Europe, TN patients are managed by many different specialities. Therefore, there is a great need for comprehensive European guidelines for the management of TN. The European Academy of Neurology asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with TN.

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Trigeminal neuralgia – diagnosis and treatment

Stine Maarbjerg, Giorgio Cruccu, Lars Bendtsen … (2017)

Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk. In a significant proportion of the patients, the demyelination is caused by a neurovascular conflict with morphological changes such as compression of the trigeminal root. However, there are also other unknown etiological factors, as only half of the CTN patients have morphological changes. STN is caused by multiple sclerosis or a space-occupying lesion affecting the trigeminal nerve. Differential diagnosis and treatment Important differential diagnoses include trigeminal autonomic cephalalgias, posttraumatic or postherpetic pain and other facial pains. First line treatment is prophylactic medication with sodium channel blockers, and second line treatment is neurosurgical intervention. Future perspectives Future studies should focus on genetics, unexplored etiological factors, sensory function, the neurosurgical outcome and complications, combination and neuromodulation treatment as well as development of new drugs with better tolerability.

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Author and article information

Contributors

Xiuhong Ge: Gxh478556386@163.com

Luoyu Wang: wangluoyu0827@hotmail.com

Lei Pan: ray0358@163.com

Haiqi Ye: 1014779539@qq.com

Xiaofen Zhu: 416769318@qq.com

Sandra Fan: sandycandy1956@hotmail.com

Qi Feng: fengqi0707@126.com

Wenhua Yu: ywh699@126.com

Zhongxiang Ding: hangzhoudzx73@126.com

Journal

Journal ID (nlm-ta): J Headache Pain

Journal ID (iso-abbrev): J Headache Pain

Title: The Journal of Headache and Pain

Publisher: Springer Milan (Milan )

ISSN (Print): 1129-2369

ISSN (Electronic): 1129-2377

Publication date (Electronic): 8 September 2022

Publication date PMC-release: 8 September 2022

Publication date Collection: 2022

Volume: 23

Issue: 1

Electronic Location Identifier: 117

Affiliations

[1 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of Radiology, , Hangzhou First People’s Hospital, Zhejiang University School of Medicine, ; Hangzhou, 310000 P.R. China

[2 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, 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 City, 310006 China

[3 ]GRID grid.268505.c, ISNI 0000 0000 8744 8924, Zhejiang Chinese Medical University, ; Hangzhou, 310000 P.R. China

[4 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of Neurosurgery, , Hangzhou First People’s Hospital, Zhejiang University School of Medicine, ; No.261, Huansha Road, Shangcheng Distric, Hangzhou, 310000 P.R. China

Article

Publisher ID: 1488

DOI: 10.1186/s10194-022-01488-8

PMC ID: 9461270

PubMed ID: 36076162

SO-VID: 4ccf13d7-b832-4714-9add-ebdc9e94b96b

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 1 August 2022

Date accepted : 24 August 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81871337

Award Recipient : Xiuhong Ge Luoyu Wang Qi Feng Zhongxiang Ding

Funded by: Zhejiang Provincial Public Welfare Research Project

Funded by: Medical and Health Technology Project of Hangzhou

Funded by: Hangzhou Agriculture and Social Development Scientific Research Guidance Project

Custom metadata

ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: amplitude of low-frequency fluctuation,central mechanism,classical trigeminal neuralgia,pathophysiology,resting-state magnetic resonance imaging

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ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: amplitude of low-frequency fluctuation, central mechanism, classical trigeminal neuralgia, pathophysiology, resting-state magnetic resonance imaging

Amplitude of low-frequency fluctuation after a single-trigger pain in patients with classical trigeminal neuralgia

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Abstract

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Conclusions

Supplementary Information

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Irish Journal of Paramedicine

Most cited references 46

Subregions of the human superior frontal gyrus and their connections.

European Academy of Neurology guideline on trigeminal neuralgia

Trigeminal neuralgia – diagnosis and treatment

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