Classical trigeminal neuralgia (CTN) refers to episodic pain that is strictly confined to the trigeminal distribution area, and the thalamus is an important component of the trigeminal sensory pathway. Probabilistic tracking imaging algorithm was used to identify specific connections between the thalamus and the cortex, in order to identify structural changes in the thalamus of patients with CTN and perform thalamic segmentation. A total of 32 patients with CTN and 32 healthy controls underwent DTI-MRI scanning (3.0 T). Differences in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) between the groups were studied. Correlation analysis was performed with clinical course and pain level. Compared to the healthy controls, patients in the CTN group had significantly reduced FA, increased AD, RD and MD in somatosensory subregion of the bilateral thalamus, increased RD in frontal subregion, increased RD and MD in motor subregion. Correlation analysis showed that patient history was positively correlated with pain grading, and that medical history was positively correlated with significantly reduced FA in somatosensory subregion, negatively correlated with increased RD and MD in motor subregion. We used DTI-based probabilistic fiber tracking to discover altered structural connectivity between the thalamus and cerebral cortex in patients with CTN and to obtain a thalamic segmentation atlas, which will help to further understand the pathophysiology of CTN and serve as a future reference for thalamic deep brain stimulation electrode implantation for the treatment of intractable pain.

中文翻译：

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基于弥散张量成像的三叉神经痛患者丘脑分割

经典三叉神经痛（CTN）是指严格局限于三叉神经分布区的阵发性疼痛，丘脑是三叉神经感觉通路的重要组成部分。采用概率跟踪成像算法识别丘脑与皮质之间的特定连接，以识别CTN患者丘脑的结构变化并进行丘脑分割。共有 32 名 CTN 患者和 32 名健康对照者接受了 DTI-MRI 扫描（3.0 T）。研究了各组之间分数各向异性（FA）、轴向扩散率（AD）、径向扩散率（RD）和平均扩散率（MD）的差异。与临床病程和疼痛水平进行相关性分析。与健康对照相比，CTN组患者双侧丘脑体感区FA显着降低，AD、RD、MD升高，额叶区RD升高，运动区RD、MD升高。相关分析显示，病史与疼痛分级呈正相关，病史与体感亚区FA显着降低呈正相关，与运动亚区RD和MD增加呈负相关。我们利用基于DTI的概率纤维追踪发现CTN患者丘脑和大脑皮层之间结构连接的改变，并获得丘脑分割图谱，这将有助于进一步了解CTN的病理生理学，并为未来丘脑深部的参考脑刺激电极植入治疗顽固性疼痛。