Associations of MRI-Derived Glymphatic System Impairment with White Matter Microstructure Damage in Trigeminal Neuralgia

Motivation: The alterations of brain metabolism and white matter microstructure in TN patients are not conclusive. Goal(s): This study aims to quantify alterations in cerebral glymphatic function and white matter microstructure in patients with TN, and to examine the relationship between these changes and their impact on clinical symptoms. Approach: The DTI-ALPS index was employed to evaluate the brain's capacity for clearing metabolic waste, while the TBSS method was utilized to analyze diffusion data. Results: The changes in white matter microstructure mediate the effects of the reduced DTI-ALPS index on pain severity and psychological well-being scores in TN patients. Impact: This research represents a pioneering investigation of cerebral glymphatic function and white matter microstructure in TN patients utilizing both DTI-ALPS index and NODDI, as well as examining their associations with pain severity and psychological well-being scores.