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Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy study

  • Functional Neuroradiology
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Abstract

Introduction

Although abnormalities in metabolite compositions in the thalamus are well described in patients with idiopathic trigeminal neuralgia (ITN), differences in distinct thalamic subregions have not been measured with proton magnetic resonance spectroscopy (1H-MRS), and whether there are correlations between thalamic metabolites and cognitive function still remain unknown.

Methods

Multivoxel MRS was recorded to investigate the metabolic alterations in the thalamic subregions of patients with ITN. The regions of interest were localized in the anterior thalamus (A-Th), intralaminar portion of the thalamus (IL-Th), posterior lateral thalamus (PL-Th), posterior medial thalamus (PM-Th), and medial and lateral pulvinar of the thalamus (PuM-Th and PuL-Th). The N-acetylaspartate to creatine (NAA/Cr) and choline to creatine (Cho/Cr) ratios were measured in the ITN and control groups. Scores of the visual analogue scale (VAS) and the Montreal Cognitive Assessment (MoCA) were analyzed to correlate with the neuroradiological findings.

Results

The NAA/Cr ratio in the affected side of PM-Th and PL-Th in ITN patients was statistically lower than that in the corresponding regions of the thalamus in controls. The NAA/Cr ratio in the affected PM-Th was negatively associated with VAS and disease duration. Furthermore, decreases of NAA/Cr and Cho/Cr were detected in the affected side of IL-Th, and lower Cho/Cr was positively correlated with MoCA values in the ITN group.

Conclusions

Our result of low level of NAA/Cr in the affected PM-Th probably serves as a marker of the pain-rating index, and decreased Cho/Cr in IL-Th may be an indicator of cognitive disorder in patients with ITN.

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Ethical Standards and Patient Consent

We declare that all human and animal studies have been approved by the First Affiliated Hospital of Xi’an Jiaotong University Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Acknowledgments

We would like to thank Editage for providing editorial assistance. This work was supported in part by the National Natural Science Foundation of China (Grant Nos. 81301207 and 81371530) and the Foundation of the First Affiliated Hospital of Xi’an Jiaotong University (Grant Nos. 2011YK.17 and 2013YK38).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, Shaanxi, 710061, People’s Republic of China

    Yuan Wang, Faxiu Bao, Shaohui Ma, Chenguang Guo, Chenwang Jin & Ming Zhang

  2. Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China

    Dan Li

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  1. Yuan Wang
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  2. Dan Li
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Correspondence to Ming Zhang.

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Wang, Y., Li, D., Bao, F. et al. Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy study. Neuroradiology 56, 685–693 (2014). https://doi.org/10.1007/s00234-014-1376-5

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  • DOI: https://doi.org/10.1007/s00234-014-1376-5

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