{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:39:14Z","timestamp":1789673954059,"version":"4.0.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>In this prospective study diffusion tensor imaging (DTI) was used to evaluate the influence of clinical and anatomical parameters on structural alterations within the fifth cranial nerve in patients with trigeminal neuralgia (TN) due to neurovascular compression.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Overall, 81 patients (40 men and 41 women; mean age 60 \u00b1 5 years) with typical TN were included who underwent microsurgical decompression. Preoperative 3.0-T high-resolution MRI and DTI were analyzed in a blinded fashion. The respective fractional anisotropy (FA) and apparent diffusion coefficient values were compared with the clinical, imaging, and intraoperative data. This study was approved by the institutional review board, and written informed consent was obtained from all patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>DTI analyses revealed significantly lower FA values within the vulnerable zone of the affected trigeminal nerve compared with the contralateral side (p = 0.05). The DTI analyses also included 3 patients without clear evidence of neurovascular conflict on preoperative MRI. No differences were seen between arterial and venous compression. Lower FA values were found 5 months after symptom onset; however, no correlation was found with the duration of symptoms or severity of compression.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>DTI analysis allows the quantification of structural alterations, even in those patients without any discernible neurovascular contact on MRI. Moreover, our findings support the hypothesis that both the arteries and veins can cause structural alterations that lead to TN. These aspects can be useful for making treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.2.jns142587","type":"journal-article","created":{"date-parts":[[2015,9,25]],"date-time":"2015-09-25T13:59:26Z","timestamp":1443189566000},"page":"823-830","source":"Crossref","is-referenced-by-count":77,"title":["Microstructural alterations in trigeminal neuralgia determined by diffusion tensor imaging are independent of symptom duration, severity, and type of neurovascular conflict"],"prefix":"10.3171","volume":"124","author":[{"given":"Juergen","family":"Lutz","sequence":"first","affiliation":[{"name":"Departments of Neuroradiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Thon","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Stahl","sequence":"additional","affiliation":[{"name":"Radiology, Hospital of the University of Munich, Campus Grosshadern, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Lummel","sequence":"additional","affiliation":[{"name":"Departments of Neuroradiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg-Christian","family":"Tonn","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Linn","sequence":"additional","affiliation":[{"name":"Departments of Neuroradiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Hinnerk","family":"Mehrkens","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 1","key":"b1-jns142587","series-title":"Med Sci Monit","first-page":"38","article-title":"Trigeminal nerve - artery contact in people without trigeminal neuralgia - MR study","volume":"13","author":"Adamczyk","year":"2007"},{"key":"b2-jns142587","series-title":"Clin Neurosurg","first-page":"473","article-title":"Neurovascular decompression: the procedure of choice?","volume":"46","author":"Apfelbaum","year":"2000"},{"key":"b3-jns142587","series-title":"J Magn Reson","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.jmr.2011.09.022","article-title":"Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI 1996","volume":"213","author":"Basser","year":"2011"},{"key":"b4-jns142587","series-title":"J Neurosci","doi-asserted-by":"publisher","first-page":"2805","DOI":"10.1523\/JNEUROSCI.4605-08.2009","article-title":"Axial diffusivity is the primary correlate of axonal injury in the experimental autoimmune encephalomyelitis spinal cord: a quantitative pixelwise analysis","volume":"29","author":"Budde","year":"2009"},{"key":"b5-jns142587","series-title":"Neurol Sci","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s10072-013-1518-2","article-title":"Arterial compression of nerve is the primary cause of trigeminal neuralgia","volume":"35","author":"Chen","year":"2014"},{"key":"b6-jns142587","series-title":"Trans Ophthalmol Soc U K","first-page":"274","article-title":"Remyelination during optic nerve compression","volume":"100","author":"Clifford-Jones","year":"1980"},{"key":"b7-jns142587","series-title":"Brain","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1093\/brain\/108.1.241","article-title":"Chronic optic nerve compression An experimental study","volume":"108","author":"Clifford-Jones","year":"1985"},{"key":"b8-jns142587","series-title":"Pain","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.pain.2013.08.029","article-title":"Abnormal trigeminal nerve microstructure and brain white matter in idiopathic trigeminal neuralgia","volume":"155","author":"DeSouza","year":"2014"},{"key":"b9-jns142587","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"532","DOI":"10.3171\/jns.2002.96.3.0532","article-title":"Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery","volume":"96","author":"Devor","year":"2002"},{"key":"b10-jns142587","series-title":"J Neuroimaging","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1111\/j.1552-6569.2010.00508.x","article-title":"High-resolution diffusion tensor imaging for the detection of diffusion abnormalities in the trigeminal nerves of patients with trigeminal neuralgia caused by neurovascular compression","volume":"21","author":"Fujiwara","year":"2011"},{"issue":"Suppl 7","key":"b11-jns142587","series-title":"Cephalalgia","first-page":"1","article-title":"Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain","volume":"8","author":"Headache Classification Committee of the International Headache Society","year":"1988"},{"key":"b12-jns142587","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1212\/01.wnl.0000256340.16766.1d","article-title":"Loss of anisotropy in trigeminal neuralgia revealed by diffusion tensor imaging","volume":"68","author":"Herweh","year":"2007"},{"key":"b13-jns142587","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1227\/00006123-199408000-00017","article-title":"Pathological findings associated with trigeminal neuralgia caused by vascular compression","volume":"35","author":"Hilton","year":"1994"},{"key":"b14-jns142587","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e32745","DOI":"10.1371\/journal.pone.0032745","article-title":"Tractography delineates microstructural changes in the trigeminal nerve after focal radiosurgery for trigeminal neuralgia","volume":"7","author":"Hodaie","year":"2012"},{"key":"b15-jns142587","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s00701-011-0957-x","article-title":"Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression","volume":"153","author":"Hong","year":"2011"},{"key":"b16-jns142587","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"216","DOI":"10.3171\/JNS-07\/07\/0216","article-title":"Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia 1967","volume":"107","author":"Jannetta","year":"2007"},{"key":"b17-jns142587","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1159\/000079961","article-title":"The evaluation of Wallerian degeneration in chronic paediatric middle cerebral artery infarction using diffusion tensor MR imaging","volume":"18","author":"Khong","year":"2004"},{"key":"b18-jns142587","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1016\/j.neuroimage.2011.01.007","article-title":"Radial diffusivity predicts demyelination in ex vivo multiple sclerosis spinal cords","volume":"55","author":"Klawiter","year":"2011"},{"key":"b19-jns142587","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.3171\/2014.2.JNS131288","article-title":"Atrophic changes in the trigeminal nerves of patients with trigeminal neuralgia due to neurovascular compression and their association with the severity of compression and clinical outcomes","volume":"120","author":"Leal","year":"2014"},{"key":"b20-jns142587","series-title":"Acta Neurochir (Wien)","first-page":"817","article-title":"Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia","volume":"152","author":"Leal","year":"2010"},{"key":"b21-jns142587","series-title":"Pain","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1016\/j.pain.2011.06.029","article-title":"Structural abnormalities of the trigeminal root revealed by diffusion tensor imaging in patients with trigeminal neuralgia caused by neurovascular compression: a prospective, double-blind, controlled study","volume":"152","author":"Leal","year":"2011"},{"key":"b22-jns142587","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s00701-013-1970-z","article-title":"Vascular compression of the trigeminal nerve in asymptomatic individuals: a voxel-wise analysis of axial and radial diffusivity","volume":"156","author":"Lin","year":"2014"},{"key":"b23-jns142587","series-title":"Eur J Radiol","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/j.ejrad.2012.11.027","article-title":"Microstructural abnormalities in the trigeminal nerves of patients with trigeminal neuralgia revealed by multiple diffusion metrics","volume":"82","author":"Liu","year":"2013"},{"key":"b24-jns142587","series-title":"Brain","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1093\/brain\/124.12.2347","article-title":"Trigeminal neuralgia: pathology and pathogenesis","volume":"124","author":"Love","year":"2001"},{"key":"b25-jns142587","series-title":"Brain Pathol","first-page":"1","article-title":"Central demyelination of the Vth nerve root in trigeminal neuralgia associated with vascular compression","volume":"8","author":"Love","year":"1998"},{"key":"b26-jns142587","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00234-014-1463-7","article-title":"Diffusion tensor imaging of the trigeminal nerve in patients with trigeminal neuralgia due to multiple sclerosis","volume":"57","author":"Lummel","year":"2015"},{"key":"b27-jns142587","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1148\/radiol.10100477","article-title":"Trigeminal neuralgia due to neurovascular compression: high-spatial-resolution diffusion-tensor imaging reveals microstructural neural changes","volume":"258","author":"Lutz","year":"2011"},{"key":"b28-jns142587","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1227\/01.NEU.0000129552.87291.87","article-title":"Trigeminal neuralgia caused by venous compression","volume":"55","author":"Matsushima","year":"2004"},{"key":"b29-jns142587","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3171\/2008.6.17620","article-title":"Radiographic evaluation of trigeminal neurovascular compression in patients with and without trigeminal neuralgia","volume":"110","author":"Miller","year":"2009"},{"key":"b30-jns142587","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1148\/radiology.176.2.2367658","article-title":"Diffusion-weighted MR imaging of anisotropic water diffusion in cat central nervous system","volume":"176","author":"Moseley","year":"1990"},{"key":"b31-jns142587","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1093\/bja\/87.1.117","article-title":"Trigeminal neuralgia\u2014pathophysiology, diagnosis and current treatment","volume":"87","author":"Nurmikko","year":"2001"},{"key":"b32-jns142587","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1227\/01.NEU.0000223501.27220.69","article-title":"Microanatomy of the central myelin-peripheral myelin transition zone of the trigeminal nerve","volume":"59","author":"Peker","year":"2006"},{"key":"b33-jns142587","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1002\/mrm.1910360612","article-title":"Toward a quantitative assessment of diffusion anisotropy","volume":"36","author":"Pierpaoli","year":"1996"},{"issue":"5","key":"b34-jns142587","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2009.8.FOCUS09156","article-title":"Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology","volume":"27","author":"Sekula","year":"2009"},{"key":"b35-jns142587","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.3171\/JNS-07\/12\/1144","article-title":"Microvascular decompression for primary trigeminal neuralgia: long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression","volume":"107","author":"Sindou","year":"2007"},{"key":"b36-jns142587","series-title":"Clin Anat","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1002\/ca.22157","article-title":"The anatomy of vascular compression in trigeminal neuralgia","volume":"27","author":"Thomas","year":"2014"},{"key":"b37-jns142587","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1097\/SCS.0000000000000984","article-title":"Effectiveness and safety of microvascular decompression surgery for treatment of trigeminal neuralgia: a systematic review","volume":"25","author":"Xia","year":"2014"},{"key":"b38-jns142587","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1148\/radiol.2282020439","article-title":"Trigeminal neuralgia: evaluation of neuralgic manifestation and site of neurovascular compression with 3D CISS MR imaging and MR angiography","volume":"228","author":"Yoshino","year":"2003"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/124\/3\/article-p823.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/124\/3\/article-p823.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/124\/3\/article-p823.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T09:58:20Z","timestamp":1709978300000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/124\/3\/article-p823.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":38,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2015.2.jns142587","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3]]}}}