Chuan Zhang, Hai Hu, Sushant K Das, Mao-Jiang Yang, Bing Li, Yang Li, Xiao-Xue Xu, Han-Feng Yang
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引用次数: 13
Abstract
Aims: To evaluate the available literature on structural and functional brain abnormalities in trigeminal neuralgia (TN) using several brain magnetic resonance imaging (MRI) techniques to further understand the central mechanisms of TN.
Methods: PubMed and Web of Science databases and the reference lists of identified studies were searched to identify potentially eligible studies through January 2019. Eligible articles were assessed for risk of bias and reviewed by two independent researchers.
Results: A total of 17 articles meeting the inclusion criteria were included in this study. The methodologic quality of the included studies was moderate. A total of 10 studies evaluated structural gray matter (GM) changes, and there was reasonable evidence that the GM of some specific brain regions changed in TN patients. In addition, there was a significant change in the root entry zone of the trigeminal nerve and in several regions of white matter. Functional changes in resting state were assessed in 9 studies. TN patients showed increased activation of resting state, and this activation was reduced in specific brain regions. There were several studies that focused on the correlation between functional parameters or strength of functional connectivity and clinical features (eg, visual analog score and pain duration), but each study focused on different brain areas or different functional connectivities within the brain.
Conclusion: There is moderate evidence that TN patients show structural brain differences in specific cortical and subcortical regions. In addition, TN patients show changes in pain-related functional connections in the resting state. Future research should focus on longitudinal designs and integration of different brain-imaging techniques.
目的:利用几种脑磁共振成像(MRI)技术评估三叉神经痛(TN)脑结构和功能异常的现有文献，以进一步了解TN的核心机制。方法:检索PubMed和Web of Science数据库以及已识别研究的参考文献列表，以确定截至2019年1月的潜在符合条件的研究。对符合条件的文章进行偏倚风险评估，并由两名独立研究人员进行评审。结果:本研究共纳入符合纳入标准的文献17篇。纳入研究的方法学质量为中等。共有10项研究评估了结构性灰质(GM)的变化，有合理证据表明TN患者的某些特定脑区GM发生了变化。此外，在三叉神经的根入口区和白质的几个区域有明显的变化。9项研究评估了静息状态下的功能变化。TN患者表现出静息状态激活增加，而这种激活在特定脑区减少。有几项研究侧重于功能参数或功能连接强度与临床特征(例如，视觉模拟评分和疼痛持续时间)之间的相关性，但每项研究都侧重于不同的大脑区域或大脑内不同的功能连接。结论:有中度证据表明，TN患者在特定的皮层和皮层下区域表现出脑结构差异。此外，TN患者在静息状态下出现疼痛相关功能连接的改变。未来的研究应着眼于纵向设计和不同脑成像技术的整合。
期刊介绍：
Founded upon sound scientific principles, this journal continues to make important contributions that strongly influence the work of dental and medical professionals involved in treating oral and facial pain, including temporomandibular disorders, and headache. In addition to providing timely scientific research and clinical articles, the journal presents diagnostic techniques and treatment therapies for oral and facial pain, headache, mandibular dysfunction, and occlusion and covers pharmacology, physical therapy, surgery, and other pain-management methods.
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