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已发表论文
原发性三叉神经痛患者脑区功能活动和脑网络连接异常：基于静息态 fMRI 的激活似然估计荟萃分析
Authors Yang H , Zhang C, Sun B, Li M, Xu X, Yang H
Received 10 October 2025
Accepted for publication 24 January 2026
Published 4 February 2026 Volume 2026:19 573011
DOI https://doi.org/10.2147/JPR.S573011
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Alaa Abd-Elsayed
Hongan Yang,1,* Chuan Zhang,1– 3,* Baijintao Sun,1,* Mingtao Li,1 Xiaoxue Xu,1 Hanfeng Yang1,3
1Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 2Innovation Center for Science and Technology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 3Biotechnology Innovation Drug Application and Transformation Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hanfeng Yang, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong, Sichuan, 637000, People’s Republic of China, Tel +86 15182927120, Email yhfctjr@163.com
Objective: This study integrates resting-state functional magnetic resonance imaging (rs-fMRI) studies to systematically identify core regions of altered regional brain activity and abnormal functional connectivity within cerebral networks in patients with primary trigeminal neuralgia (PTN).
Methods: We systematically searched PubMed, Web of Science, and EMBASE for rs-fMRI studies (between January 2010 and June 2025) comparing PTN patients with healthy controls (HCs). Through a standardized data extraction protocol, coordinates of divergent brain functional metrics and network connectivity parameters were collected. Ultimately, we included 16 studies, of which 14 were related to functional specific indices (375 patients) and 5 to functional connectivity (204 patients). Separate modality-specific Activation Likelihood Estimation (ALE) meta-analyses were conducted for studies employing Amplitude of Low-Frequency Fluctuation (ALFF/fALFF), Regional Homogeneity (ReHo), and Degree Centrality (DC), to reflect their unique neurophysiological meanings.
Results: ALE analysis revealed index-specific alteration patterns with limited spatial overlap. The ALFF/fALFF analysis identified consistent hypoactivity in the left medial prefrontal cortex. In contrast, ReHo and DC analyses converged to show hyperactivity in the posterior cerebellar lobe and temporal pole. Notably, Seed-based functional connectivity analyses yielded no convergent findings, and limbic system activation was highly heterogeneous.
Conclusion: Our meta-analysis demonstrates that PTN involves complex, multidimensional brain remodeling, not a dysfunction of a single “pain center.” The distinct spatial patterns identified by different rs-fMRI metrics underscore their complementary value in uncovering PTN pathophysiology. These findings advance the understanding of PTN’s central mechanisms, support the development of targeted interventions, and highlight the need to differentiate neurophysiological metrics and clinical subtypes in future research.
Keywords: primary trigeminal neuralgia, resting-state functional magnetic resonance imaging, meta-analysis, regional brain activity, functional connectivity
1Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 2Innovation Center for Science and Technology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 3Biotechnology Innovation Drug Application and Transformation Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hanfeng Yang, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong, Sichuan, 637000, People’s Republic of China, Tel +86 15182927120, Email yhfctjr@163.com
Objective: This study integrates resting-state functional magnetic resonance imaging (rs-fMRI) studies to systematically identify core regions of altered regional brain activity and abnormal functional connectivity within cerebral networks in patients with primary trigeminal neuralgia (PTN).
Methods: We systematically searched PubMed, Web of Science, and EMBASE for rs-fMRI studies (between January 2010 and June 2025) comparing PTN patients with healthy controls (HCs). Through a standardized data extraction protocol, coordinates of divergent brain functional metrics and network connectivity parameters were collected. Ultimately, we included 16 studies, of which 14 were related to functional specific indices (375 patients) and 5 to functional connectivity (204 patients). Separate modality-specific Activation Likelihood Estimation (ALE) meta-analyses were conducted for studies employing Amplitude of Low-Frequency Fluctuation (ALFF/fALFF), Regional Homogeneity (ReHo), and Degree Centrality (DC), to reflect their unique neurophysiological meanings.
Results: ALE analysis revealed index-specific alteration patterns with limited spatial overlap. The ALFF/fALFF analysis identified consistent hypoactivity in the left medial prefrontal cortex. In contrast, ReHo and DC analyses converged to show hyperactivity in the posterior cerebellar lobe and temporal pole. Notably, Seed-based functional connectivity analyses yielded no convergent findings, and limbic system activation was highly heterogeneous.
Conclusion: Our meta-analysis demonstrates that PTN involves complex, multidimensional brain remodeling, not a dysfunction of a single “pain center.” The distinct spatial patterns identified by different rs-fMRI metrics underscore their complementary value in uncovering PTN pathophysiology. These findings advance the understanding of PTN’s central mechanisms, support the development of targeted interventions, and highlight the need to differentiate neurophysiological metrics and clinical subtypes in future research.
Keywords: primary trigeminal neuralgia, resting-state functional magnetic resonance imaging, meta-analysis, regional brain activity, functional connectivity