Altered Brain Functional Network Dynamics in Classic Trigeminal Neuralgia: A Resting-state Functional Magnetic Resonance Imaging Study
Abstract Background: Accumulating studies have indicated a wide range of brain alterations in structure and function of Classic trigeminal neuralgia (CTN). Given the dynamic nature of pain experience, the exploration of temporal fluctuations in interregional activity covariance may enhance the understanding of pain process in brain. The present study aimed to characterize the temporal features of functional connectivity (FC) states as well as topological alteration in CTN.Methods: Resting-state fMRI (rs-fMRI) and three-dimensional T1-weighted images were obtained from 41 CTN patients and 43 matched healthy controls (HC). After group independent component analysis, sliding window based dynamic functional network connectivity (dFNC) analysis was applied to investigate specific FC states and related temporal properties. Then the dynamics in whole brain topological organization were estimated by calculating coefficient of variation of graph-theoretical properties. The further correlation analysis were performed between all those measurements and clinical data.Results: Two distinct states were identified, of which the state 2, characterized by complicate coupling between default mode network (DMN) and cognitive control network (CC) and tight connections within DMN, expressed more in CTN patients, presented as increased fractional windows and dwell time. Also, patients switched less frequently between states than HC. Regarding to dynamic topological analysis, disruptions in global graph-theoretical properties (including network efficiency and small-worldness) were observed in patients, coupled with decreased variability in nodal efficiency of anterior cingulate cortex (ACC) in salience network (SN) and thalamus, caudate in subcortical network (SC). The variation of topological properties showed negative correlation with disease duration and attack frequency.Conclusions: The present study indicated disrupted flexibility of brain topological organization under persistent noxious stimulation and further highlighted the important role of “dynamic pain connectome” regions (including DMN/CC/SN) in pathophysiology of CTN from temporal fluctuation aspect. Additionally, the findings provided supplementary evidence for current knowledge about the aberrant cortical-subcortical interaction in pain development.