Effect Of Flurbiprofen Axetil On Low-frequency Fluctuation Amplitude Of Resting-state Functional Magnetic Resonance Imaging In Trigeminal Neuralgia

Objective:Using resting-state functional magnetic resonance imaging(fMRI)and low-frequency oscillation amplitude(ALFF)methods,the changes of brain function in patients with trigeminal neuralgia after administration of flurbiprofen axetil and the possible central mechanism of flurbiprofen axetil were studied.Methods:From January 2017 to February 2018,20 patients with trigeminal neuralgia diagnosed by neurosurgery department of the General Hospital of the Chinese People’s Liberation Army(PLA)who needed surgical treatment met the inclusion and exclusion criteria.Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were assessed after admission.Visual Analogue Scale(VAS)was used to evaluate the pain intensity before and after flurbiprofen axetil injection.The resting fMRI data of 20 patients with trigeminal neuralgia before and after treatment with flurbiprofen axetil injection were collected by 1.5T magnetic resonance imaging instrument.The resting fMRI data were preprocessed by SPM(Statistical Parametric Mapping)and DPABI(a toolbox for Data Processing&Analysis for Brain Imaging g)software.ALFF method was used to analyze and compare the amplitude of low frequency oscillation of spontaneous brain activity in patients with trigeminal neuralgia before and after flurbiprofen axetil administration.The general data,VAS score and ALFF value of the patients were analyzed by SPSS 17.0.ALFF values were expressed by mean plus minus standard deviation(x±s),and then the differences before and after administration were compared.Results:There were different degrees of anxiety and depression in patients with trigeminal neuralgia.The VAS score of trigeminal neuralgia patients after administration of flurbiprofen axetil injection was lower than that before administration,and the pain relieved significantly(P<0.01).The ALFF values of right dorsolateral prefrontal lobe,bilateral medial prefrontal lobe and right middle cingulate gyrus were lower in patients with trigeminal neuralgia after flurbiprofen axetil injection at rest than before administration(P<0.01).There were significant differences in VAS score and ALFF value before and after administration.Conclusion:Long-term pain causes anxiety and depression in patients with trigeminal neuralgia.Patients with trigeminal neuralgia had less pain after flurbiprofen axetil injection.The spontaneous nerve activity in the right dorsolateral prefrontal lobe,bilateral medial prefrontal lobe and right cingulate gyrus was decreased compared with that before administration.The above results suggest that the analgesic effect of flurbiprofen axetil may have a central mechanism,which can inhibit the abnormal parts of brain function caused by chronic pain stimulation and thus reduce pain.However,the specific central mechanism needs further study and discussion.