• Maud Parise, Tadeu Takao Almodovar Kubo, Thomas Martin Doring, Gustavo Tukamoto, Maurice Vincent, and Emerson Leandro Gasparetto.
• Department of Radiology, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP:21941-913, Brazil. parise@infolink.com.br.
• J Headache Pain. 2014 Mar 24; 15: 17.

BackgroundChronic pain disorders are presumed to induce changes in brain grey and white matters. Few studies have focused CNS alterations in trigeminal neuralgia (TN).MethodsThe aim of this study was to explore changes in white matter microstructure in TN subjects using diffusion tensor images (DTI) with tract-based spatial statistics (TBSS); and cortical thickness changes with surface based morphometry. Twenty-four patients with classical TN (37-67 y-o) and 24 healthy controls, matched for age and sex, were included in the study.ResultsComparing patients with controls, no diffusivity abnormalities of brain white matter were detected. However, a significant reduction in cortical thickness was observed at the left cuneus and left fusiform cortex in the patients group. The thickness of the fusiform cortex correlated negatively with the carbamazepine dose (p = 0.023).ConclusionsSince the cuneus and the fusiform gyrus have been related to the multisensory integration area and cognitive processing, as well as the retrieval of shock perception conveyed by Aδ fibers, our results support the role of these areas in TN pathogenesis. Whether such changes occurs as an epiphenomenon secondary to daily stimulation or represent a structural predisposition to TN in the light of peripheral vascular compression is a matter of future studies.

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