ANTIC version 1

  • Research type

    Research Study

  • Full title

    Advanced neuroimaging to study the central pain pathways in trigeminal neuralgia ( tic douloureux) pre and post-microvascular decompression

  • IRAS ID

    259563

  • Contact name

    Joanna Zakrzewska

  • Contact email

    jzakrzewska@nhs.net

  • Sponsor organisation

    University College London Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 4 months, 31 days

  • Research summary

    This pilot study will determine if central changes in pain pathways are responsible for differences in phenotype and prognosis of trigeminal neuralgia (TN) patients.
    TN is a rare but highly disabling facial pain condition characterized by recurrent, unilateral brief electric shock-like pains triggered by innocuous stimuli. The underlying pathophysiology of TN is as yet unclear. Significant compression of the trigeminal nerve by a blood vessel and atrophy is associated with classical TN but it is not known how this leads to pain generation.
    Diffusion weighted imaging is a magnetic resonance imaging (MRI) technique that can be applied to assess the microstructural integrity of white matter tracts and cranial nerves. The two most commonly used diffusion tensor imaging (DTI) parameters are mean diffusivity (MD) and functional anisotropy (FA). Another imaging technique is functional MRI in the resting state which allows for measuring functional connectivity parameters without the need for performing tasks during image acquisition. Recent pilot studies have shown that changes can be found in both these investigations in patients with TN and these change after surgical treatments.
    In this pilot study 10 patients with classical TN will be compared with a healthy age matched control group. After phenotyping and full assessment baseline imaging will be done 4 weeks before the MVD and then 6 months after MVD. The imaging takes about 60 minutes.
    Using special computer programs and help from a neuroradiologist, MRI physicist and neurosurgeon we will analyse the data and determine how it changes after a microvascular decompression. Correlations between pain freedom, recurrence rates and diffusion MR parameters will be examined to measure any changes following surgery especially in those who may not get pain relief.
    We will compare TN patients to healthy controls who have no facial pain.

  • REC name

    East Midlands - Leicester Central Research Ethics Committee

  • REC reference

    19/EM/0043

  • Date of REC Opinion

    26 Feb 2019

  • REC opinion

    Further Information Favourable Opinion