基于DTI的三叉神经痛脑白质结构异常及其与临床特征的相关性

Objective: To explore the microstructure abnormalities of white matter (WM) throughout the brain in patients with primary trigeminal neuralgia (PTN) using tract-based spatial statistics (TBSS). Methods: Whole brain DTI scanning was performed on 38 PTN patients and 38 age and sex matched healthy volunteers. DTI data were processed with FSL software package. The different brain regions of FA, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated, and then the correlation between these parameters and visual analogue scale (VAS) were evaluated in PTN patients. Results: Compared with the controls, widespread decrease of FA value in corpus callosum, coronal radiata, left superior longitudinal fasciculus, left inferior longitudinal fasciculus and inferior frontal-occipital fasciculus were demonstrated in PTN patients. Besides these regions, the elevated MD and RD values were also distributed extensively in posterior thalamic radiation, internal capsule, external capsule, fornix and right superior longitudinal fasciculus. Increased AD value was found in bilateral anterior limbs of internal capsule, left posterior limb of internal capsule, bilateral superior coronal radiata and superior longitudinal fasciculus. In addition, the mean VAS was negatively correlated with FA value (r=-0.502, P=0.001) and positively associated with MD value (r=0.437, P=0.006) in left superior longitudinal fasciculus in PTN patients. Conclusion: Elevation of MD and RD without FA alterations in thalamus and internal capsule may be relatively characteristic in PTN patient, and FA and MD values extracted from left superior longitudinal fasciculus may become alternative indicators for assessing facial pain in PTN patients.