• Dylan Henssen, Jurriaan Dijk, Robin Knepflé, Matthijs Sieffers, Anouk Winter, and Kris Vissers.
• Department of Anatomy, Donders Institute for Brain, Cognition & Behavior, Radboud university medical center, Nijmegen, Netherlands; Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, Netherlands. Electronic address: dylan.henssen@radboudumc.nl.
• Neuroimage Clin. 2019 Jan 1; 24: 102039.

BackgroundVarious studies reported changes in grey matter volumes and modifications in functional connectivity of cortical and subcortical structures in patients suffering from trigeminal neuralgia (TN) and trigeminal neuropathic pain (TNP). This study meta-analyzed the concordant structural and functional changes in foci and provide further understanding of the anatomy and biology of TN/TNP.MethodsRelevant articles on magnetic resonance imaging (MRI) and functional MRI in TN/TNP, published before August 2018, were searched for on PubMed and Embase. Following exclusion of unsuitable studies, a meta-analysis was performed using activation likelihood estimation (ALE).ResultsIn total, 322 paper were identified, 11 of which could be included based on the predefined inclusion and exclusion criteria. Eight papers, totaling 279 subjects, discussing structural changes and four papers, totaling 102 subjects, discussing functional changes were included (i.e., one paper investigated both structural and functional alterations). ALE analysis showed that in TN/TNP, grey matter decreases are found in the thalamus, (anterior) cingulate gyrus, bilateral striatum, the superior-, middle- and transverse temporal gyrus, subcallosal gyrus, the bilateral insular cortex, the pre- and postcental gyrus, the middle frontal gyrus bilaterally and the anterior cerebellar lobe. Grey matter increases were seen in the periaqueductal grey (PAG). Increased resting state functional organization was found within the bilateral middle- and superior frontal gyri, the (posterior) cingulate cortex and the thalamus/pulvinar.ConclusionsStructural and functional changes meta-analyzed in this paper may contribute to elucidating the central pathophysiological mechanisms involved in TN/TNP. These results may be used as biomarkers to predict the response to medication and, ideally, in the future to offer personalized treatments.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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