# No Glymphatic Dysfunction in Trigeminal Neuralgia: A Preliminary Study

## TL;DR

This study found no evidence of glymphatic dysfunction in trigeminal neuralgia patients, suggesting it is not linked to the condition or affected by surgery.

## Contribution

This is the first preliminary study to investigate glymphatic function in trigeminal neuralgia using DTI-ALPS indices.

## Key findings

- No significant differences in glymphatic function were found between TN patients and healthy controls.
- Surgery did not alter glymphatic clearance in TN patients.
- No correlations were found between glymphatic function and clinical parameters like age or disease duration.

## Abstract

Trigeminal neuralgia (TN) patients are at risk for glymphatic dysfunction due to their prolonged headaches and sleep disturbances.

The aim of this study is to compare the glymphatic function changes in TN patients with healthy controls, to investigate whether there are differences in glymphatic function after decompression surgery, and to examine their relationship with clinical parameters.

The data for this hybrid design study were obtained from the OpenNeuro dataset titled “A large‐scale dataset of pre‐ and post‐surgical MRI data in patients with chronic trigeminal neuralgia.” The DTI‐ALPS index values were calculated for 62 TN patients with normal brain MRIs and 35 age‐ and sex‐matched healthy controls, as well as for 53 TN patients who had both preoperative and postoperative diffusion tensor imaging. Statistical analyses involved nonparametric tests and Spearman correlation to assess differences between groups and relationships with clinical variables such as age, disease duration, and Sindou grading.

There were no significant differences in DTI‐ALPS indices between TN patients and controls. Additionally, preoperative and postoperative comparisons in the TN cohort revealed no significant changes in glymphatic function following surgery. Furthermore, no correlations were observed between DTI‐ALPS indices and clinical parameters, including patient age, disease duration, or the severity of neurovascular compression.

The findings of this preliminary study suggest that glymphatic dysfunction is not a contributing factor in the pathogenesis of TN and that microvascular decompression surgery does not alter glymphatic clearance. These results indicate that the underlying mechanisms of TN may be independent of glymphatic impairment, despite the presence of sleep disturbances in this population.

In this study investigating cross‐sectional and longitudinal DTI‐ALPS changes in patients with trigeminal neuralgia, no DTI‐ALPS alterations were detected in trigeminal neuralgia patients.