Radiomics nomogram based on MRI water imaging identifying symptomatic nerves of patients with primary trigeminal neuralgia: A preliminary study.

The study proposes a combined nomogram based on radiomics features from magnetic resonance neurohydrography and clinical features to identify symptomatic nerves in patients with primary trigeminal neuralgia. We retrospectively analyzed 140 patients with clinically confirmed trigeminal neuralgia. Out of these, 24 patients constituted the external validation set, while the remaining 116 patients contributed a total of 231 nerves, comprising 118 symptomatic nerves, and 113 normal nerves. Radiomics features were extracted from the MRI water imaging (t2-mix3d-tra-spair). Radiomics feature selection was performed using L1 regularization-based regression, while clinical feature selection utilized univariate analysis and multivariate logistic regression. Subsequently, radiomics, clinical, and combined models were developed by using multivariate logistic regression, and a nomogram of the combined model was drawn. The performance of nomogram in discriminating symptomatic nerves was assessed through the area under the curve (AUC) of receiver operating characteristics, accuracy, and calibration curves. Clinical applications of the nomogram were further evaluated using decision curve analysis. Five clinical factors and 13 radiomics signatures were ultimately selected to establish predictive models. The AUCs in the training and validation cohorts were 0.77 (0.70-0.84) and 0.82 (0.72-0.92) with the radiomics model, 0.69 (0.61-0.77) and 0.66 (0.53-0.79) with the clinical model, 0.80 (0.74-0.87), and 0.85 (0.76-0.94) with the combined model, respectively. In the external validation set, the AUCs for the clinical, radiomics, and combined models were 0.70 (0.60-0.79), 0.78 (0.65-0.91), and 0.81 (0.70-0.93), respectively. The calibration curve demonstrated that the nomogram exhibited good predictive ability. Moreover, The decision curve analysis curve indicated shows that the combined model holds high clinical application value. The integrated model, combines radiomics features from magnetic resonance neurohydrography with clinical factors, proves to be effective in identify symptomatic nerves in trigeminal neuralgia. The diagnostic efficacy of the combined model was notably superior to that of the model constructed solely from conventional clinical features.

Altered spontaneous brain activity in lumbar disc herniation patients: insights from an ALE meta-analysis of neuroimaging data.

Objective: To explore the characteristics of spontaneous brain activity changes in patients with lumbar disc herniation (LDH), and help reconcile the contradictory findings in the literature and enhance the understanding of LDH-related pain. Materials and methods: PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), SinoMed, and Wanfang databases were searched for literature that studies the changes of brain basal activity in patients with LDH using regional homogeneity (ReHo) and amplitude of low-frequency fluctuation/fraction amplitude of low-frequency fluctuation (ALFF/fALFF) analysis methods. Activation likelihood estimation (ALE) was used to perform a meta-analysis of the brain regions with spontaneous brain activity changes in LDH patients compared with healthy controls (HCs). Results: A total of 11 studies were included, including 7ALFF, 2fALFF, and 2ReHo studies, with a total of 269 LDH patients and 277 HCs. Combined with the data from the ALFF/fALFF and ReHo studies, the meta-analysis results showed that compared with HCs, LDH patients had increased spontaneous brain activity in the right middle frontal gyrus (MFG), left anterior cingulate cortex (ACC) and the right anterior lobe of the cerebellum, while they had decreased spontaneous brain activity in the left superior frontal gyrus (SFG). Meta-analysis using ALFF/fALFF data alone showed that compared with HCs, LDH patients had increased spontaneous brain activity in the right MFG and left ACC, but no decrease in spontaneous brain activity was found. Conclusion: In this paper, through the ALE Meta-analysis method, based on the data of reported rs-fMRI whole brain studies, we found that LDH patients had spontaneous brain activity changes in the right middle frontal gyrus, left anterior cingulate gyrus, right anterior cerebellar lobe and left superior frontal gyrus. However, it is still difficult to assess whether these results are specific and unique to patients with LDH. Further neuroimaging studies are needed to compare the effects of LDH and other chronic pain diseases on the spontaneous brain activity of patients. Furthermore, the lateralization results presented in our study also require further LDH-related pain side-specific grouping study to clarify this causation. Systematic review registration: PROSPERO, identifier CRD42022375513.