Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis

Fröhlich K, Winder K, Linker R, Engelhorn T, Dörfler A, Lee DH, Hilz MJ, Schwab S, Seifert F (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Cephalalgia Sage Publications

Book Volume: 38

Pages Range: 1326-1334

Journal Issue: 7

DOI: 10.1177/0333102417737788

Abstract

Background It has been proposed that multiple sclerosis lesions afflicting the pontine trigeminal afferents contribute to trigeminal neuralgia in multiple sclerosis. So far, there are no imaging studies that have evaluated interactions between supratentorial lesions and trigeminal neuralgia in multiple sclerosis patients. Methods We conducted a retrospective study and sought multiple sclerosis patients with trigeminal neuralgia and controls in a local database. Multiple sclerosis lesions were manually outlined and transformed into stereotaxic space. We determined the lesion overlap and performed a voxel-wise subtraction analysis. Secondly, we conducted a voxel-wise non-parametric analysis using the Liebermeister test. Results From 12,210 multiple sclerosis patient records screened, we identified 41 patients with trigeminal neuralgia. The voxel-wise subtraction analysis yielded associations between trigeminal neuralgia and multiple sclerosis lesions in the pontine trigeminal afferents, as well as larger supratentorial lesion clusters in the contralateral insula and hippocampus. The non-parametric statistical analysis using the Liebermeister test yielded similar areas to be associated with multiple sclerosis-related trigeminal neuralgia. Conclusions Our study confirms previous data on associations between multiple sclerosis-related trigeminal neuralgia and pontine lesions, and showed for the first time an association with lesions in the insular region, a region involved in pain processing and endogenous pain modulation.

Authors with CRIS profile

Katharina Fröhlich Medizinische Fakultät Ralf Linker Department of Neurology Tobias Martin Engelhorn Department of Neuroradiology Arnd Dörfler
De-Hyung Lee Medizinische Fakultät Max-Josef Hilz Heisenbergprofessur für Neuroimmunologie Stefan Schwab Lehrstuhl für Neurologie Frank Seifert Medizinische Fakultät

How to cite

APA:

Fröhlich, K., Winder, K., Linker, R., Engelhorn, T., Dörfler, A., Lee, D.-H.,... Seifert, F. (2018). Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis. Cephalalgia, 38(7), 1326-1334. https://dx.doi.org/10.1177/0333102417737788

MLA:

Fröhlich, Katharina, et al. "Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis." Cephalalgia 38.7 (2018): 1326-1334.

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