Trigeminal neuralgia (TN) is the type of disease you wouldn’t wish on anyone. It’s characterized by extreme pain in the trigeminal nerve, which innervates the face. It’s often described as a stabbing, burning, or shocking sensation. Depending on the type of TN someone has, it can come in bursts for seconds, minutes, or hours, or it could be constant and slightly more subdued. TN often affects only one side of the face. It usually targets people over 50, and affects mostly women. There are various treatments to help manage the symptoms, but not all patients find relief through them. To learn more about TN, click here.
Sometimes, the cause of trigeminal neuralgia is relatively clear: a blood vessel exerting pressure on the nerve, a mess of arteries, an injury, a tumor. In other cases, sometimes called classic TN, the source is more elusive.
A recent study examined MRI scans of 62 patients and came across some fascinating observations.Previously, little was known about how TN affected brain structure. The scans showed that patients with trigeminal neuralgia display altered brain structure and function.
The researchers analyzed the scans, searching for changes in grey matter volume and connectivity between different regions of the brain.
They found that TN patients who experienced pain on the right side had greatly reduced grey matter in the precentral gyrus, prefrontal cortex, cerebella tonsil, hypothalamus, nucleus accubens, and thalmus.
TN patients who were affected on the left side also showed reduced grey matter, but in precentral gyrus, inferior frontal gyrus, ventral striatum, putamen, and thalamus.
The scientists also found that that TN patients affected on the right side had a weakened connection between important frontal gyri, while TN patients affected on the left side had weakened connections on left frontal gyri.
Some of these brain changes, particularly regarding volume and connectivity in the thalamus, seemed to hold a moderate link to how long TN patients experience pain for. Scientists already knew that the thalamus processed the pain TN patients felt, and now it looks like it also may play a role in producing it.
Another takeaway from this research is that, when TN episodes become chronic, the repeated distress actually causes physical volumes changes in the regions of the brain that process both physical and emotional pain.
This new research offers a fascinating insight, which may change the way researchers think about and treat trigeminal neuralgia.
