Elizabeth RozhnovaN.V. Sklifosovsky Research Institute of Emergency Medicine , Russian Federation
Title: Assessing trigeminal microstructure changes in patients with classical trigeminal neuralgia
To establish the diagnosis of classic trigeminal neuralgia (TN), it is necessary to confirm the structural changes in the trigeminal nerve root. The use of MRI in the FIESTA mode makes it possible to evaluate three-dimensional images of the trigeminal nerve roots, to identify a violation of the straightness of their course and atrophy. To diagnose microstructural changes in the trigeminal nerve root, it is possible to apply a sequence of diffusion-tensor images (DTI) with the determination of the fractional anisotropy index (FA). As a result of our research, the method for determining FA was refined. To establish the side of the disease, we used the difference in values between the healthy and symptomatic sides (∆FA) instead of the absolute values on the symptomatic side. The indicator statistically significant for the detection of microstructural changes was Me ∆FA = 0.075 [0.029; 0.146], p = 0.03. We used this indicator in the diagnosis of controversial cases of neurovascular conflict (NVC) - I degree according to Sindou, in which the vessel interacts with the nerve root without visible structural changes. In the study group (20 patients with classic TN with unilateral arterial NVC of the I degree according to Sindou) Me ∆FA = 0.083 and in the control group (20 patients without pain with unilateral arterial NVC of I-II degree according to Sindou), Me ∆FA = 0.031, p < 0.001.
Rozhnova Elizabeth graduated from Kursk State Medical University. Since 2016 she has been studying clinical neurophysiology, functional diseases in neurosurgery and radiosurgery in N.V. Sklifosovsky Research Institute of Emergency Medicine in Moscow. Area of interest - facial pain, diagnostic methods and treatment. Since 2019 she began postgraduate studies/ PhD study in the field of diagnostic studies of the radicular functions of the trigeminal nerve before and after surgical interventions or radiosurgery.