Trigeminal Neuralgia (TN) is a unique neuropathic pain condition, characterized by paroxysmal unilateral facial pain, invariably triggered by innocuous tactile stimulation. It is widely agreed that a neurovascular compression, causing morphological alteration of the trigeminal root, is the predominant aetiology of Classical TN. The aim of the present study is to assess somatosensory system damage in patients with TN attending the Neuropathic Pain Centre of the Department of Human Neuroscience, Sapienza University of Rome. To do so, we plan to enrol 30 patients with a definite diagnosis of TN. Each patient will fill in a structured questionnaire and undergo a formal standardised quantitative sensory testing protocol. For the clinical workup of TN, a Magnetic Resonance Imaging is required. These scans will be analysed to measure trigeminal nerve root volume, neurovascular interface geometry and its location along the root circumference and cortical thickness and cortical complexity in the main sensory cortices of the brain. The participants of this study are already familiar with all the above-mentioned techniques, which were also used in previous publications. Clinical information obtained by the structured questionnaire, sensory profiles derived by the quantitative sensory testing and neuroimaging measures will be ultimately correlated among them. The project is expected to last 12 months.
Identifying how trigeminal root vascular compression shapes symptoms distribution and induce subtle sensory alterations or morphologic changes in the brain regions associated with tactile and pain procession will improve our understanding of the pathogenetic mechanisms involved in Classical Trigeminal Neuralgia. This will ultimately lead to better treatment of the patients, both reducing pain occurrences than overall patients¿ discomfort, determining an improvement in clinical care of Trigeminal Neuralgia.