ArticleBMC neurology2021
The thalamus in trigeminal neuralgia: structural and metabolic abnormalities, and influence on surgical response.
Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Neuromodulation of the central nervous system for facial pain.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Pooled it
- Pooled it
- Clinical and cognitive effects of external trigeminal nerve stimulation (eTNS) in neurological and psychiatric disorders: a systematic review and meta-analysis.Molecular psychiatry · 2023Pooled it
- Thalamic changes in patients with chronic facial pain.Neuroradiology · 2025Article
- Stratification of surgical outcomes in trigeminal neuralgia using multimodal data.Brain communications · 2025Article
- Pathophysiology and Management of Refractory Trigeminal Neuralgia.Current neurology and neuroscience reports · 2024Review
- Exploring the Thalamus as a Target for Neuropathic Pain Management: An Integrative Review.Cureus · 2024Review
- Imaging the neural substrate of trigeminal neuralgia pain using deep learning.Frontiers in human neuroscience · 2023Article
- Electrophysiological and computational analysis of CaMolecular brain · 2022Article
- Spatiotemporal dynamics of brain function during the natural course in a dental pulp injury model.European journal of nuclear medicine and molecular imaging · 2022Article
- Pre-operative Limbic System Functional Connectivity Distinguishes Responders From Non-responders to Surgical Treatment for Trigeminal Neuralgia.Frontiers in neurology · 2021Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedically-refractory trigeminal neuralgia (TN) can be treated successfully with operative intervention, but a significant proportion of patients are non-responders despite undergoing technically successful surgery. The thalamus is a key component of the trigeminal sensory pathway involved in transmitting facial pain, but the role of the thalamus in TN, and its influence on durability of pain relief after TN surgery, are relatively understudied. We aimed to test the hypothesis that variations in thalamic structure and metabolism are related to surgical non-response in TN.
methodsWe performed a longitudinal, peri-operative neuroimaging study of the thalamus in medically-refractory TN patients undergoing microvascular decompression or percutaneous balloon compression rhizotomy. Patients underwent structural MRI and MR spectroscopy scans pre-operatively and at 1-week following surgery, and were classified as responders or non-responders based on 1-year post-operative pain outcome. Thalamus volume, shape, and metabolite concentration (choline/creatine [Cho/Cr] and N-acetylaspartate/creatine [NAA/Cr]) were evaluated at baseline and 1-week, and compared between responders, non-responders, and healthy controls.
resultsTwenty healthy controls and 23 patients with medically-refractory TN treated surgically (17 responders, 6 non-responders) were included. Pre-operatively, TN patients as a group showed significantly larger thalamus volume contralateral to the side of facial pain. However, vertex-wise shape analysis showed significant contralateral thalamus volume reduction in non-responders compared to responders in an axially-oriented band spanning the outer thalamic circumference (peak p = 0.019). Further, while pre-operative thalamic metabolite concentrations did not differ between responders and non-responders, as early as 1-week after surgery, long-term non-responders showed a distinct decrease in contralateral thalamic Cho/Cr and NAA/Cr, irrespective of surgery type, which was not observed in responders.
conclusionsAtrophy of the contralateral thalamus is a consistent feature across patients with medically-refractory TN. Regional alterations in preoperative thalamic structure, and very early post-operative metabolic changes in the thalamus, both appear to influence the durability of pain relief after TN surgery.
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