Altered Structural and Functional Abnormalities of Hippocampus in Classical Trigeminal Neuralgia: A Combination of DTI and fMRI Study

PURPOSE: Diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) were applied to speculate the altered structural and functional abnormalities within the hippocampus in classical trigeminal neuralgia (CTN) patients by detecting the alteration of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and regional homogeneity (ReHo). Patients and Methods. Multimodal MRI dataset (DTI and fMRI) and clinical indices (pain and neuropsychological scores) were collected in 27 CTN patients and 27 age- and gender-matched healthy controls (HC). Two independent-sample t-tests were performed to compare the ADC, FA, and ReHo values in hippocampus areas between CTN patients and HC. Correlation analyses were applied between all the DTI and fMRI parameters within the hippocampus and the VAS (visual analog scale), MoCA (Montreal cognitive assessment), and CDR (clinical dementia rating) scores. RESULTS: CTN patients showed a significantly increased FA values in the right hippocampus (t = 2.387, P = 0.021) and increased ReHo values in the right hippocampus head (voxel P < 0.001, cluster P < 0.05, FDR correction) compared with HC. A positively significant correlation was observed between the ReHo values and MOCA scores in the right hippocampus head; FA values were also positively correlated with MOCA scores in the right hippocampus. CONCLUSION: CTN patients demonstrated an abnormality of structures and functions in the hippocampus, which may help to provide novel insights into the neuropathologic change related to the pain-related dysfunction of CTN.