Sex differences in trigeminal neuralgia: a focus on radiological and clinical characteristics.
Multi-hit model
Neurovascular conflict
Paroxysmal pain
Sex differences
Trigeminal neuralgia
Trigeminal root
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
03
05
2023
accepted:
20
06
2023
medline:
14
11
2023
pubmed:
12
7
2023
entrez:
12
7
2023
Statut:
ppublish
Résumé
It is well established that trigeminal neuralgia is more prevalent in females than in males. Neurovascular compression with morphological changes of the trigeminal root represents the most recognized etiological factor. However, other factors may play a role in the framework of a multi-hit model. The primary aim of this study was to investigate sex differences in radiological and clinical characteristics of trigeminal neuralgia to better understand the multifactorial origin of this peculiar neuropathic pain condition. In this cross-sectional study patients with a definite diagnosis of primary trigeminal neuralgia were consecutively enrolled. Each patient underwent 3T MRI with sequences dedicated to the study of neurovascular compression. Major morphological changes of the trigeminal root were quantitatively assessed. Clinical characteristics were systematically collected through a dedicated questionnaire. A logistic regression model was implemented to predict radiological and clinical characteristics based on sex. A total of 114 patients with classical (87) or idiopathic trigeminal neuralgia (27) were enrolled. Female sex was predictive for idiopathic trigeminal neuralgia. Male sex was predictive, among the comorbidities and clinical characteristics, for hypertension, the involvement of the left side and the second trigeminal division, alone or with the ophthalmic division. The preponderance of TN in the female sex and the association between idiopathic TN and the female sex suggest the role of additional etiological factors in the framework of a multi-hit model. The identification of clinical variables predicted by sex suggests the possibility that distinct phenotypes, with peculiar pathophysiological and therapeutic aspects, may occur in females and males.
Sections du résumé
BACKGROUND
BACKGROUND
It is well established that trigeminal neuralgia is more prevalent in females than in males. Neurovascular compression with morphological changes of the trigeminal root represents the most recognized etiological factor. However, other factors may play a role in the framework of a multi-hit model. The primary aim of this study was to investigate sex differences in radiological and clinical characteristics of trigeminal neuralgia to better understand the multifactorial origin of this peculiar neuropathic pain condition.
METHODS
METHODS
In this cross-sectional study patients with a definite diagnosis of primary trigeminal neuralgia were consecutively enrolled. Each patient underwent 3T MRI with sequences dedicated to the study of neurovascular compression. Major morphological changes of the trigeminal root were quantitatively assessed. Clinical characteristics were systematically collected through a dedicated questionnaire. A logistic regression model was implemented to predict radiological and clinical characteristics based on sex.
RESULTS
RESULTS
A total of 114 patients with classical (87) or idiopathic trigeminal neuralgia (27) were enrolled. Female sex was predictive for idiopathic trigeminal neuralgia. Male sex was predictive, among the comorbidities and clinical characteristics, for hypertension, the involvement of the left side and the second trigeminal division, alone or with the ophthalmic division.
DISCUSSION
CONCLUSIONS
The preponderance of TN in the female sex and the association between idiopathic TN and the female sex suggest the role of additional etiological factors in the framework of a multi-hit model. The identification of clinical variables predicted by sex suggests the possibility that distinct phenotypes, with peculiar pathophysiological and therapeutic aspects, may occur in females and males.
Identifiants
pubmed: 37436558
doi: 10.1007/s10072-023-06923-5
pii: 10.1007/s10072-023-06923-5
pmc: PMC10641090
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4465-4472Informations de copyright
© 2023. The Author(s).
Références
Cephalalgia. 2018 Jan;38(1):1-211
pubmed: 29368949
Int J Legal Med. 2011 Mar;125(2):199-204
pubmed: 20107826
JAMA Neurol. 2021 Jun 1;78(6):747-754
pubmed: 33616625
Brain. 2015 Feb;138(Pt 2):311-9
pubmed: 25541189
Ann Surg. 1980;192(4):518-25
pubmed: 6968543
Pain. 2014 Aug;155(8):1464-1471
pubmed: 24785270
Clin Radiol. 2013 Feb;68(2):203-13
pubmed: 22889460
Neurology. 2016 Jul 12;87(2):220-8
pubmed: 27306631
J Neurol Sci. 1991 Sep;105(1):22-8
pubmed: 1795166
Headache. 2014 Nov-Dec;54(10):1574-82
pubmed: 25231219
Fam Med Community Health. 2020 Feb 16;8(1):e000262
pubmed: 32148735
Acta Neurochir (Wien). 2019 Aug;161(8):1589-1598
pubmed: 31240582
Pain. 2019 Nov;160(11):2603-2611
pubmed: 31373951
J Neurosurg. 2019 Feb 1;132(2):631-638
pubmed: 30717058
N Engl J Med. 2020 Aug 20;383(8):754-762
pubmed: 32813951
Brain. 2022 Aug 27;145(8):2882-2893
pubmed: 35325067
Acta Neurochir (Wien). 2002 Jan;144(1):1-12; discussion 12-3
pubmed: 11807642
Brain. 2020 Dec 1;143(12):3619-3628
pubmed: 33301567
Brain. 2020 Feb 1;143(2):531-540
pubmed: 31930326
J Neurol Neurosurg Psychiatry. 2021 Mar;92(3):233-241
pubmed: 33361408
Proc Natl Acad Sci U S A. 2022 Sep 20;119(38):e2119630119
pubmed: 36095216
J Basic Clin Physiol Pharmacol. 2020 Jul 10;:
pubmed: 32649294
Am J Roentgenol Radium Ther Nucl Med. 1956 Aug;76(2):346-50
pubmed: 13340058
Neurol Genet. 2021 Jan 11;7(1):e550
pubmed: 33977138
Cephalalgia. 2020 Feb;40(2):129-221
pubmed: 32103673
Ann Neurol. 1990 Jan;27(1):89-95
pubmed: 2301931
Biology (Basel). 2022 Aug 10;11(8):
pubmed: 36009828
Cephalalgia. 2020 Nov;40(13):1502-1510
pubmed: 32791919
Eur J Neurol. 2019 Jun;26(6):831-849
pubmed: 30860637
Cephalalgia. 2020 Jul;40(8):767-777
pubmed: 31928344
Headache. 2014 Jul-Aug;54(7):1173-83
pubmed: 24842632
Clin Neurophysiol. 2022 Oct;142:52-58
pubmed: 35970059
Lancet Neurol. 2020 Sep;19(9):784-796
pubmed: 32822636
Headache. 2021 Jun;61(6):817-837
pubmed: 34214179
N Engl J Med. 1996 Apr 25;334(17):1077-83
pubmed: 8598865
Exp Neurol. 1982 Mar;75(3):755-63
pubmed: 7060700
Med Hypotheses. 2005;65(6):1179-82
pubmed: 16084672
Cephalalgia. 2015 Oct;35(12):1077-84
pubmed: 25616608