Combined structural and functional assessment of the ophthalmic trigeminal pathway in healthy adults: a feasibility study with preliminary reference data
10 affiliations
- 1Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Sardinia, Italy
- 2Department of Ophthalmology, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy
- 3Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Lombardia, Italy
- 4Department of Ophthalmology, Universita degli Studi di Catania, Catania, Sicily, Italy
- 5Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy
- 6Department of Internal Medicine and Medical Specialties (DIMI), Universita degli Studi di Genova, Genoa, Liguria, Italy
- 7Department of Neuroradiology, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy
- 8S.C Neuroradiology, Ospedale Santa Corona Pietra Ligure, Pietra Ligure, Liguria, Italy
- 9Department of Ophthalmology, Universita degli Studi Magna Graecia di Catanzaro, Catanzaro, Calabria, Italy
- 10Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano, Lombardia, Italy
Abstract
Background: Structural and functional evaluation of the ophthalmic division (V1) of the trigeminal nerve lacks standardised approaches integrating high-resolution anatomical imaging with complementary neurophysiological testing.
Objectives: To evaluate the feasibility of a multimodal assessment of the ophthalmic trigeminal pathway using high-resolution non-contrast MRI, blink reflex testing (BRT) and Quantitative Cutaneous Sensory Testing (QEST) and to report preliminary descriptive anatomical, neurophysiological and cutaneous sensory measurements in healthy adults.
Methods: In this prospective observational study, 20 healthy volunteers (11 males and 9 females; mean age 32 years) underwent 3-T MRI, BRT and QEST. MRI included three-dimensional isotropic T1-weighted sequences for morphometric assessment of the left frontal and supraorbital nerves. Blink reflex latencies and QEST thresholds were assessed bilaterally.
Results: Frontal and supraorbital nerves were visualised in all subjects. Mean frontal nerve calibre was 0.160 cm×0.160 cm; proximal and distal supraorbital segments measured 0.148 cm×0.135 cm and 0.140 cm×0.114 cm, respectively. All blink reflex responses were present. R2 latencies were strongly correlated between sides, and the mean absolute inter-side differences were 0.63 ms for R1, 2.03 ms for ipsilateral R2 and 1.17 ms for contralateral R2. QEST thresholds demonstrated no significant lateral differences.
Conclusions: This study supports the feasibility of a combined MRI–blink reflex–QEST protocol and provides preliminary descriptive measurements of complementary structural, reflex and cutaneous sensory domains of the ophthalmic trigeminal pathway. Larger, age-diverse cohorts and prospective clinical validation are required before these measurements can be used as normative intervals or for clinical decision-making.
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BibTeX
@article{gaeta2026combined,
title = {{Combined structural and functional assessment of the ophthalmic trigeminal pathway in healthy adults: a feasibility study with preliminary reference data}},
author = {Alessandro Gaeta and Giovanni Ottonelli and Silvia Ferraro and Antonio La Rosa and Francesca Gallia and Chiara Polini and Lorenza Narcisi and Luca Alessandro Cappellini and Jacopo Gandolfo and Maria Angela Romeo and Giovanni Savini and Letterio Salvatore Politi and Giuseppe Giannaccare and Alessandra Di Maria},
journal = {BMJ Open Ophthalmology},
year = {2026},
month = nov,
doi = {10.1136/bmjophth-2026-002871},
url = {https://doi.org/10.1136/bmjophth-2026-002871},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Combined structural and functional assessment of the ophthalmic trigeminal pathway in healthy adults: a feasibility study with preliminary reference data
AU - Alessandro Gaeta
AU - Giovanni Ottonelli
AU - Silvia Ferraro
AU - Antonio La Rosa
AU - Francesca Gallia
AU - Chiara Polini
AU - Lorenza Narcisi
AU - Luca Alessandro Cappellini
AU - Jacopo Gandolfo
AU - Maria Angela Romeo
AU - Giovanni Savini
AU - Letterio Salvatore Politi
AU - Giuseppe Giannaccare
AU - Alessandra Di Maria
PY - 2026
DA - 2026/11/03
JO - BMJ Open Ophthalmology
DO - 10.1136/bmjophth-2026-002871
UR - https://doi.org/10.1136/bmjophth-2026-002871
AB - Background: Structural and functional evaluation of the ophthalmic division (V1) of the trigeminal nerve lacks standardised approaches integrating high-resolution anatomical imaging with complementary neurophysiological testing. Objectives: To evaluate the feasibility of a multimodal assessment of the ophthalmic trigeminal pathway using high-resolution non-contrast MRI, blink reflex testing (BRT) and Quantitative Cutaneous Sensory Testing (QEST) and to report preliminary descriptive anatomical, neurophysiological and cutaneous sensory measurements in healthy adults. Methods: In this prospective observational study, 20 healthy volunteers (11 males and 9 females; mean age 32 years) underwent 3-T MRI, BRT and QEST. MRI included three-dimensional isotropic T1-weighted sequences for morphometric assessment of the left frontal and supraorbital nerves. Blink reflex latencies and QEST thresholds were assessed bilaterally. Results: Frontal and supraorbital nerves were visualised in all subjects. Mean frontal nerve calibre was 0.160 cm×0.160 cm; proximal and distal supraorbital segments measured 0.148 cm×0.135 cm and 0.140 cm×0.114 cm, respectively. All blink reflex responses were present. R2 latencies were strongly correlated between sides, and the mean absolute inter-side differences were 0.63 ms for R1, 2.03 ms for ipsilateral R2 and 1.17 ms for contralateral R2. QEST thresholds demonstrated no significant lateral differences. Conclusions: This study supports the feasibility of a combined MRI–blink reflex–QEST protocol and provides preliminary descriptive measurements of complementary structural, reflex and cutaneous sensory domains of the ophthalmic trigeminal pathway. Larger, age-diverse cohorts and prospective clinical validation are required before these measurements can be used as normative intervals or for clinical decision-making.
SN - 2397-3269
ER -