【摘要】 目的 探讨经典型三叉神经痛(classic trigeminal neuralgia, CTN)患者皮层下核结构的灰质体积(gray matter volume,GMV)及基于GMV的结构协方差网络(structural covariance network, SCN)的变化特征。材料与方法 前瞻性采集55例CTN患者和59例健康对照者的3D-T1WI结构像数据，提取双侧丘脑、海马及杏仁核亚区的GMV，并根据每个受试者的GMV计算基于组水平的SCN。分别比较两组的GMV及SCN相关参数的差异。结果 CTN患者表现出丘脑亚区中左侧前腹侧核、旁中央核、束旁核、右侧侧背部、中央内侧核、腹侧连结核和双侧腹内侧核的体积减小(P<0.001)；杏仁核亚区中右侧附基底核、前杏仁核区、皮质-杏仁核过渡区和双侧皮质核的体积减小(P<0.001)；海马亚区中左侧海马角4-体部和齿状回颗粒细胞层-体部的体积减小(P≤0.001)。偏相关分析表明，CTN患者组的疼痛时长与左侧腹内侧核、左侧束旁核、右侧腹内侧核及右侧中央内侧核的体积呈负相关(分别为r_s=-0.397、P=0.003,r_s=-0.435、P<0.001,r_s=-0.306、P=0.023,r_s=-0.323、P=0.016)，焦虑自评量表评分与右侧皮质-杏仁核过渡区、右侧附基底核体积呈正相关(分别为r_s=0.257、P=0.059,r_s=0.349、P=0.009)。CTN组SCN的小世界指数显著低于对照组(P<0.05)。结论 CTN患者皮层下核结构重要亚区出现体积减小以及网络属性的改变，这些发现表明皮层下核结构和结构协方差网络特性的改变作为CTN的潜在结构特征标志物，有望提供疼痛治疗的新靶点。更多还原

【Abstract】 Objective:To explore the variation characteristics of gray matter volume(GMV) and GMV-based structural covariance network(SCN) of subcortical nuclear structures in patients with classic trigeminal neuralgia(CTN).Materials and Methods:The 3D-T1WI structural image data of 55 patients with classic CTN and 59 healthy controls were prospectively collected, and the GMV of bilateral thalamus, hippocampus and amygdala subregions was extracted, and calculate the SCN at the group level based on the GMV of each subject.Compare the differences in GMV and SCN parameters between the two groups respectively.Results:CTN patients showed volume reduction in the left anteriorventral, paracentral, parafascicular, right laterodorsal, central medial, reuniens medial ventral and bilateral ventromedial in the subregions of the thalamus(P<0.001).In the amygdala subregion, the volumes of the right accessory basal nucleus, the anterior amygdaloid area, the cortico-amygdaloid transition area, and the bilateral cortical nucleus(P<0.001) decreased; in the hippocampal subregion, the volume of the left cornu ammonis 4-body and the granule cell layer of the dentate gyrus-body(P ≤ 0.001) decreased.Partial correlation analysis indicated that the duration of pain in the CTN patient group was negatively correlated with the volumes of the left ventromedial, the left parafascicular, the right ventromedial and the right central medial(r_s=-0.397, P=0.003; r_s=-0.435, P<0.001; r_s=-0.306, P=0.023 and r_s=-0.323, P=0.016, respectively), the score of the self-rating anxiety scale was positively correlated with the volume of the right cortico-amygdaloid transition area and the right accessory basal nucleus(r_s=0.257, P=0.059 and r_s=0.349, P=0.009, respectively).The small-world index of SCN in the CTN group was significantly lower than that in the control group(P<0.05).Conclusions:The important subregions of subcortical nuclear structure in CTN patients show volume reduction and changes in network properties.These findings suggest that the alterations in subcortical nuclear structure and structural covariance network characteristics, as potential structural feature markers of CTN, are expected to provide new targets for pain treatment.更多还原