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Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis

Fröhlich, K; Winder, K; Linker, RA; Engelhorn, T; Dörfler, A; Lee, D; Schwab, S; (2018) Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis. Cephalalgia , 38 (7) pp. 1326-1334. 10.1177/0333102417737788. Green open access

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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 evaluated interactions between supratentorial lesions and trigeminal neuralgia in multiple sclerosis patients. METHODS: We conducted a retrospective study and sought for multiple sclerosis patients with trigeminal neuralgia and controls in a local database. Multiple sclerosis lesions manually outlined and transformed into stereotaxic space. We determined the lesion overlap and performed a voxel-wise subtraction analysis. Second, we conducted a voxel-wise non-parametric analysis using the Liebermeister test. RESULTS: From 12210 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.

Type: Article
Title: Supratentorial lesions contribute to trigeminal neuralgia in multiple sclerosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/0333102417737788
Publisher version: http://dx.doi.org/10.1177/0333102417737788
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Voxel-based lesion symptom mapping, multiple sclerosis, trigeminal neuralgia, facial pain
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/1571815
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