BACKGROUND: This study employed resting-state functional magnetic resonance imaging (rs-fMRI) to examine alterations in the brain's spontaneous activity during rest in patients with trigeminal neuralgia (TN) affecting different sides of the face. METHODS: We included 30 cases each of right-sided TN (R_TN), left-sided TN (L_TN), and healthy controls (HC). We analyzed changes in amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) values between L_TN and R_TN groups in comparison to HC. We also explored relationships between disease duration, visual analog scale scores, and ALFF/ReHo values in significant brain regions. RESULTS: Relative to HC, L_TN exhibited increased ALFF values in the left superior temporal gyrus and reduced values in the bilateral middle frontal gyrus. Elevated ReHo values were observed in the left cerebellar Crus2 region, while decreased values were identified in the bilateral middle frontal gyrus and left dorsolateral superior frontal gyrus. In R_TN, ALFF values increased in the left precentral gyrus and decreased in the right middle frontal gyrus; ReHo values remained unchanged. Correlation analysis indicated positive associations between disease duration and ALFF value of left superior temporal gyrus, as well as ReHo value of left cerebellar Crus2 region in L_TN. CONCLUSIONS: This research indicated that both left and right TN patients exhibited changes in spontaneous brain activity during rest. These alterations predominantly occurred contralateral to the pain. These identified brain regions are implicated in pain perception, regulation, and emotional processing, suggesting their relevance to the modulation and adaptive changes of the human brain in response to trigeminal neuralgia.
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