Poster No:
2161
Submission Type:
Abstract Submission
Authors:
Anton Pashkov1,2,3, Elena Filimonova1,3, Galina Moisak1,3,4, Azniv Martirosyan1, Boris Zaitsev1, Jamil Rzaev1,3,4
Institutions:
1Federal Center of Neurosurgery, Novosibirsk, 2Novosibirsk State Technical University, Novosibirsk, 3Novosibirsk State Medical University, Novosibirsk, 4Novosibirsk State University, Novosibirsk, Russian Federation
First Author:
Anton Pashkov
Federal Center of Neurosurgery|Novosibirsk State Technical University|Novosibirsk State Medical University
Novosibirsk|Novosibirsk|Novosibirsk
Co-Author(s):
Elena Filimonova
Federal Center of Neurosurgery|Novosibirsk State Medical University
Novosibirsk|Novosibirsk
Galina Moisak
Federal Center of Neurosurgery|Novosibirsk State Medical University|Novosibirsk State University
Novosibirsk|Novosibirsk|Novosibirsk, Russian Federation
Jamil Rzaev
Federal Center of Neurosurgery|Novosibirsk State Medical University|Novosibirsk State University
Novosibirsk|Novosibirsk|Novosibirsk, Russian Federation
Introduction:
Trigeminal neuralgia (TN) is a prevalent chronic pain disorder characterized by recurrent, intense, and sharp pain. Prior research has established that biomarkers derived from MRI imaging hold promise in aiding clinicians to tailor personalized treatment schedules (Hung et al., 2021). However, most of these studies have focused exclusively on the trigeminal system, overlooking the fact that chronic pain leads to widespread neural reorganization throughout the brain (Liu et al., 2022). Among the brain regions affected by prolonged pain, the thalamus stands out for its prominent role in sensory processing, including the processing of nociceptive signals. Several recent publications have shown significant reductions in gray matter volume (GMV) in the thalamus of patients with trigeminal neuralgia (Wu et al., 2020; Danyluk et al., 2021). However, previous studies investigating thalamic GMV alterations have often treated the thalamus as a single entity, without examining structural changes at the level of individual nuclei. In this study, we aimed to provide a more detailed analysis of pain-induced remodeling in the thalamus by parcellating it into 25 distinct nuclei.
Methods:
The total number of participants involved in the study was ninety one: patients with trigeminal neuralgia (n = 62) and age- and gender-matched healthy participants (n = 29). MR imaging data were acquired using a 3T system (Ingenia, Philips Healthcare, The Netherlands) equipped with a 16-channel receiver head coil. Fully automatic surface-based MR morphometry of high-resolution T1-WI was performed with FreeSurfer v7.2.0 software. Segmentation of the thalamic nuclei was done following the approach described in (Iglesias et al., 2018). One-way ANCOVA with post hoc Tukey tests was employed to compare mean values of grey matter volumes between groups while controlling for age, gender and intracranial volume variables. The follow-up data was collected 6 months post-surgery.
Results:
We revealed three clusters of nuclei showing significant differences between groups. First cluster consisted of intralaminar nuclei such as centromedial (CM), parafascicular (Pf) and paratenial (Pt) nuclei. Second cluster included lateral (LGN) and medial geniculate bodies (MGN) as well as thalamic nuclei belonging to the ventral group, mainly related to sensory processing. Third cluster was composed of so-called associative thalamic nuclei, namely, medial dorsal lateral (MDl), lateral dorsal (LD) and pulvinar nuclei. The most pronounced differences were shown in LGN (right LGN - right-sided pain vs controls: t(82) = 3.94, p < 0.001; left LGN - right-sided pain vs controls: t(82) = 4.63, p < 0.001) and medial pulvinar nucleus (right PuM - left-sided pain vs controls: t(82) = 3.9, p < 0.001). Furthermore, we were able to provide evidence that the Pf nucleus was the sole nucleus to experience an increase in GMV following the surgical intervention. As a result, its median volume became comparable to that of the control group, and there was a significant difference observed between the pre- and post-surgery conditions (W = 585, p = 0.2 and W = 397, p = 0.037, respectively).
Conclusions:
In this study, we have demonstrated that thalamic nuclei underwent significant changes in gray matter volume in patients with trigeminal neuralgia. Particularly noteworthy are the significant alterations occurring in the intralaminar nuclei and nuclei associated with the processing of visual and auditory signals, as opposed to the ventral group nuclei involved in nociceptive processing. Moreover, our findings indicate that only the right parafascicular nucleus exhibited a substantial increase in volume subsequent to successful surgical intervention. Our results are consistent with previous studies, which have shown that stimulating the CM-Pf complex in patients with chronic pain unresponsive to other treatments may provide a viable alternative therapeutic approach (Weigel et al., 2004; Abdallat et al., 2021).
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Modeling and Analysis Methods:
Segmentation and Parcellation
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Subcortical Structures 1
Keywords:
Morphometrics
MRI
Neurological
Pain
Sub-Cortical
Thalamus
1|2Indicates the priority used for review
Provide references using author date format
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2. Danyluk H (2021), 'The thalamus in trigeminal neuralgia: structural and metabolic abnormalities, and influence on surgical response', BMC Neurolology, vol. 21, pp. 1-14.
3. Iglesias JE (2018), 'A probabilistic atlas of the human thalamic nuclei combining ex vivo MRI and histology', Neuroimage, vol. 183, pp. 314-326.
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