Altered structure and functional connection in patients with classical trigeminal neuralgia

Tsai, Yuan-Hsiung; Yuan, Rui; Patel, Dharni; Chandrasekaran, Subhashini; Weng, Hsu–Huei; Yang, Jing‐Tang; Lin, Ching Po; Biswal, Bharat B.

doi:10.1002/hbm.23696

Cited by 60 publications

(70 citation statements)

References 66 publications

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“…49 And pain could lead to lower connectivity between precentral gyrus and superior frontal gyrus which participate in the processing of painrelated emotional and cognition in classical trigeminal neuralgia. 50 It is similar to our findings.…”

Section: Discussionsupporting

confidence: 93%

<p>Brain Functional Alternations of the Pain-related Emotional and Cognitive Regions in Patients with Chronic Shoulder Pain</p>

Li¹,

Yan²,

Wang³

et al. 2020

JPR

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Objective: Chronic shoulder pain (CSP) is a common health problem associated with shoulder dysfunction and persistent pain for many different reasons. However, the studies of pain-related functional brain regions in CSP have been poorly investigated. The main purpose of our study was to observe whether there are abnormal functional changes in brain regions in patients with CSP by using functional magnetic resonance imaging (fMRI). Patients and Methods:We compared the differences of brain regions between 37 patients with CSP and 24 healthy controls (HC) using regional homogeneity (ReHo) method. The patients with chronic shoulder pain and healthy controls were matched for age and gender. Brain regions which had abnormal ReHo values were defined as seed region of interests. The approach of seed-based functional connectivity (FC) was further performed to analyze the connectivity between the seeds and whole brain regions. The relationship between abnormal regions and current clinical pain was also evaluated. Results: Compared to healthy controls, the patients with CSP showed increased ReHo values in the left middle temporal gyrus and decreased ReHo values in right orbitofrontal cortex (OFC). The seed-based analyses demonstrated decreased connectivity between the right OFC and right rectus, superior frontal gyrus in patients with chronic shoulder pain. However, a correlation between ReHo values and clinical characteristics in CSP patients was not found. Conclusion: The observed results indicate that there are abnormal ReHo values in brain regions of patients with CSP, especially in the OFC and middle temporal gyrus. Our findings demonstrate that the experience of CSP patients may be mainly associated with cognitiveaffective pain processing, rather than nociception.

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Section: Discussionsupporting

confidence: 93%

<p>Brain Functional Alternations of the Pain-related Emotional and Cognitive Regions in Patients with Chronic Shoulder Pain</p>

Li¹,

Yan²,

Wang³

et al. 2020

JPR

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“…Indeed, we observed that alterations in the functional connectivity strength of prefrontal-amygdala circuitry were significantly correlated with increased depression and anxiety. Recently, a study of TN patients also did not find the changes of functional connectivity in PAG- and insula- related circuits (Tsai et al, 2018 ). To note, the pain modulatory pathways involve projections from PAG to brainstem nuclei, including the rostroventral medulla (RVM) and the locus coeruleus, to the dorsal horn of the spinal cord (Basbaum and Fields, 1978 ; Ossipov et al, 2010 ).…”

Section: Discussionmentioning

confidence: 98%

Dysregulation of Pain- and Emotion-Related Networks in Trigeminal Neuralgia

Zhang

Mao

Pan

et al. 2018

Front. Hum. Neurosci.

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Classical trigeminal neuralgia (TN) is a severe neuropathic facial pain disorder associated with increased risks of anxiety and depression. Converging evidence suggests that chronic pain pathophysiology involves dysfunctional pain-related and emotion-related networks. However, whether these systems are also among the culprit networks for TN remains unclear. Here, we aimed to assess TN-related anatomical and functional brain anomalies in pain-related and emotion-related networks. We investigated differences in gray matter (GM) volume and the related resting-state functional connectivity (rsFC) between 29 classical TN patients and 34 matched healthy controls. Relationships between brain measurement alterations, clinical pain and emotional states were identified. A longitudinal observation was further conducted to determine whether alterations in the brain could renormalize following pain relief. Reduced GM volumes in the bilateral amygdala, periaqueductal gray (PAG) and right insula were found in TN patients compared with healthy control subjects. Whole-brain rsFC analyses with the four above-mentioned anatomical regions as seeds identified three significantly altered functional circuits, including amygdala-DLPFC, amygdala-mPFC and amygdala-thalamus/putamen circuitry. The amygdala-DLPFC and amygdala-mPFC circuits were associated with clinical pain duration and emotional state ratings, respectively. Further longitudinal analysis found that rsFC strength abnormalities in two fronto-limbic circuits (left amygdala/left DLPFC and right amygdala/right PFC) were resolved after pain relief. Together, structural and functional deficits in pain-related and emotion-related networks were associated with TN patients, as demonstrated by our multimodal results. Pain relief had protective effects on brain functional connectivity within fronto-limbic circuits. Our study provides novel insights into the pathophysiology of TN, which may ultimately facilitate advances in TN intervention.

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“…The NAc projects to various executive, emotional, and motor regions and is considered a master regulator of motivational drive (40,41). Although a decrease in NAc gray matter volume occurs in states of chronic pain (as with heroin addiction), the activity in this region collectively increases (30,(42)(43)(44). Human imaging studies also have helped to elucidate the neurobiological mechanisms contributing to the transition from acute to chronic pain, which is fundamental for the development of efficient treatment tools.…”

Section: Nucleus Accumbensmentioning

confidence: 99%

The Mesolimbic Dopamine System in Chronic Pain and Associated Affective Comorbidities

Serafini

Pryce

Zachariou

2020

Biological Psychiatry

157

121

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Chronic pain is a complex neuropsychiatric disorder characterized by sensory, cognitive, and affective symptoms. Over the past 2 decades, researchers have made significant progress toward understanding the impact of mesolimbic dopamine circuitry in acute and chronic pain. These efforts have provided insights into the circuits and intracellular pathways in the brain reward center that are implicated in sensory and affective manifestations of chronic pain. Studies have also identified novel therapeutic targets as well as factors that affect treatment responsiveness. Dysregulation of dopamine function in the brain reward center may further promote comorbid mood disorders and vulnerability to addiction. This review discusses recent clinical and preclinical findings on the neuroanatomical and neurochemical adaptations triggered by prolonged pain states in the brain reward pathway. Furthermore, this discussion highlights evidence of mechanisms underlying comorbidities among pain, depression, and addiction.

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Altered structure and functional connection in patients with classical trigeminal neuralgia

Cited by 60 publications

References 66 publications

<p>Brain Functional Alternations of the Pain-related Emotional and Cognitive Regions in Patients with Chronic Shoulder Pain</p>

<p>Brain Functional Alternations of the Pain-related Emotional and Cognitive Regions in Patients with Chronic Shoulder Pain</p>

Dysregulation of Pain- and Emotion-Related Networks in Trigeminal Neuralgia

The Mesolimbic Dopamine System in Chronic Pain and Associated Affective Comorbidities

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