Correlation study between multiplanar reconstruction trigeminal nerve angulation and trigeminal neuralgia

Objectives: Despite neurovascular compression (NVC) is now widely accepted mechanism of trigeminal neuralgia (TN), there were some patients found no NVC, and also NVC was found in asymptomatic individuals. Here, we aimed to explore the correlation between multiplanar reconstruction (MPR) trigeminal nerve angulation (TNA) and TN. Methods From May 2020 to November 2021, 50 healthy controls were enrolled as control group (CG), 95 patients with primary TN were enrolled as observation group (OG), which was further subtyped into young patients (YP), middle-aged patients (MP) and old patients (OP) according to onset age of TN symptoms. Patients was also divided into patients with or without evoked actions according to the presence of evoked actions or not. Bilateral TNA measurements were carried out in OG and CG, image parameters were compared between different groups or subgroups. All images were interpreted by two radiologists who were blinded to the study. Result No statistical difference of bilateral TNA of CG was found, TNA of OG was significantly smaller than CG. In OG, TNA on the affected side was significantly smaller than the unaffected side. TNA showed a positive correlation with age, as TNA on the affected side of YP was significantly smaller than MP and OP. Patients with evoked actions showed smaller TNA than patients without evoked actions. Conclusions This study suggested that TNA might play a role in TN, small TNA could be a risk factor of TN. Furthermore, patients with small TNA are more likely to combine with evoked actions., but more studies are needed to explore the exact role of TNA in TN.