Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy
Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy
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特发性三叉神经痛中丘脑代谢改变与认知功能障碍：多体素光谱
DOI：
10.1007/s00234-014-1376-5
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发表时间：
2014
期刊：
影响因子：
2.8
通讯作者：
Zhang Ming
中科院分区：
文献类型：
--
作者：
Wang Yuan;Li Dan;Bao Faxiu;Ma Shaohui;Guo Chenguang;Zhang Ming
虽然在特发性三叉神经痛（ITN）患者中丘脑代谢物成分的异常得到了很好的描述，但尚未用质子磁共振波谱（1H-MRS）测量不同丘脑亚区的差异，丘脑代谢产物与认知功能之间是否存在相关性尚不清楚ITN患者的分区。感兴趣的区域位于前丘脑（A-Th）、丘脑板内部分（IL-Th）、后外侧丘脑（PL-Th）、后内侧丘脑（PM-Th）和丘脑枕内侧和外侧（PuM-Th和PuL-Th）。测定ITN组和对照组的N-乙酰天冬氨酸/肌酸（NAA/Cr）和胆碱/肌酸（Cho/Cr）比值。视觉模拟评分（VAS）和蒙特利尔认知评估（MoCA）的分数进行了分析，与神经放射学findings. ResultsNAA/Cr比值在患侧的PM-Th和PL-Th ITN患者低于相应的区域的丘脑在对照组。受影响的PM-Th中NAA/Cr比值与VAS和疾病持续时间呈负相关。此外，NAA/Cr和Cho/Cr的下降检测在患侧IL-Th，和较低的Cho/Cr与MoCA值在ITN group.ConclusionsOur结果的影响PM-Th的NAA/Cr的低水平可能作为一个标记的疼痛评分指数，和降低Cho/Cr IL-Th可能是一个指标的认知障碍ITN患者。
IntroductionAlthough 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.MethodsMultivoxel 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). TheN-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.ResultsThe 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.ConclusionsOur 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.