原发性三叉神经痛患者小脑灰质体积变化

Abnormalities of Cerebellar Gray Matter Volume in Patients with Idiopathic Trigeminal Neuralgia

目的:应用基于体素形态学技术(VBM)测量原发性三叉神经痛(ITN)患者小脑内灰质体积(GMV)的变化情况,探讨其与疼痛调节的关系。方法:3D-TOF-MRA及FIESTA序列扫描上有明确神经血管接触或压迫关系的ITN患者43例,分为左侧面部疼痛组(LITN,n=21)和右侧面部疼痛组(RITN,n=22),分别与年龄、性别及受教育程度相匹配的25例健康对照组图像数据进行比较。LITN组与RITN组图像数据进行比较。结果:与对照组比较,LITN组在左侧小脑半球小叶ⅧA、ⅧB区GMV增加。RITN组较对照组在小脑蚓部Ⅸ区、双侧半球小叶ⅧA、ⅦB区、右侧半球小叶Ⅵ区及右侧CrⅠ区GMV增加。RITN组与LITN组比较在小脑未见GMV差异。结论:与对照组相比,ITN患者脑内小脑GMV有改变,小脑在ITN形成和发展过程中扮演重要角色。

Objective：To observe the abnormalities of cerebellar gray matter volume in patients with idiopathic trigeminal neuralgia（ITN）by using voxel-based morphometry（VBM）,and discuss the relationship between the change and pain.Methods：There were 43 patients with the nerve vessel compression in the normal MRI images as the experimental group.There were 25 health persons with the matched age,sex and years of education as control group.Gray matter between both groups were analyzed.In the experimental group,gray matter between the left idiopathic trigeminal neuralgia（LITN,n=21）and the right idiopathic trigeminal neuralgia（RITN,n=22）were analyzed.Results：Compared with control group,gray matter volume in the left cerebellar lobeⅧA and ⅧB increased in LITN group.Compared with control group,gray matter volume in the both sides cerebellar lobeⅧA,the vermisⅨ,the right cerebellar lobeⅥ,and the right cerebellar crusⅠ（CrⅠ）increased in RITN group.Compared with LITN group,gray matter volume in the left cerebellum,the both sides insula,the left cingulate gyrus,the right postcentral gyrus increased,and gray matter volume in the right thalamus reduced in the RITN group.Conclusion：Compared with the control group,there are abnormal gray matter volume in patients with ITN.The cerebellum plays an important role in the process and development of the ITN.