Abstract: Objective The objective of this study was to study the abnormal changes in brain structure and function in patients with primary trigeminal neuralgia (PTN) by using multimodal magnetic resonance technology,to further explore the pathological mechanisms of PTN,and to identify potential therapeutic targets for PTN.Methods T1WI high-resolution MRI scans and resting-state functional MRI scans were performed on 22 PTN patients and 20 healthy individuals.Brain areas where there were differences in brain grey matter volume(GMV)between patients and healthy individuals was identifide by using voxel-based morphological analysis.The brain regions with variations in GMV were used as areas of interest to establish seed points and to detected brain links with significantly different functional connetivity between the two groups.Results Compared to healthy controls,the total GMV was reduced in the PTN patient group.Among the grey matter structures,the GMV of the left anterior cingulate gyrus (ACC),right postcentral gyrus,right middle temporal gyrus,left hippocampus,and left superior temporal gyrus were reduced in PTN patients compared to healthy controls,while the GMV of the patient's left ACC was negatively correlated with the course of the disease.The functional links between the left ACC and the right inferior frontal gyrus,the left insula,and the right cerebellar Crus II area were also enhanced in PTN patients compared to healthy subjects.Conclusion ACC is an important part of the pathological mechanism associated with the central nervous system of PTN,while ACC may be a potential therapeutic target for PTN.

Key words: Primary trigeminal neuralgia, Pathological mechanism, Magnetic Resonance Imaging

摘要： 目的 利用多模态磁共振技术研究原发性三叉神经痛(PTN)患者脑结构与功能改变的特点,进一步探究PTN的病理机制,筛选PTN潜在的治疗靶点。方法 对22例PTN患者及20例健康者行T1WI高分辨率MRI扫描及静息态功能MRI扫描,首先进行基于体素的形态学分析,得出患者较健康者脑灰质体积(GMV)存在差异的脑区,再将灰质体积存在变化的脑区作为兴趣区设立种子点,明确两组间功能具有明显差异的脑区链接。结果 与健康对照组相比,PTN患者组脑灰质总体积减小,脑灰质结构中,PTN患者的左侧前扣带回(ACC)、右侧中央后回、右侧颞中回、左侧海马体、左侧颞上回的GMV较健康对照组减少;患者左侧ACC的GMV与病程呈负相关。同时PTN患者左侧ACC与右侧额下回、左侧岛叶、右侧小脑Crus Ⅱ区的功能链接较健康者增强。结论 ACC是PTN中枢神经系统相关病理机制中的重要一环,同时ACC可能是PTN的潜在治疗靶点。

关键词: 原发性三叉神经痛, 磁共振成像, 病理机制