Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evalu...Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evaluates the efficacy of fully endoscopic MVD for dcTN and presents our early experience.Methods:This retrospective study included patients with dcTN who underwent fully endoscopic MVD in the Department of Neurosurgery,the First Affiliated Hospital,Zhejiang University School of Medicine from November 2020 to February 2023.We recorded basic patient clinical information,clinical outcomes,offending vessels,complications,and recurrences,and assessed outcomes via the Barrow Neurological Institute(BNI)pain intensity score and the numeric rating scale(NRS)score.Results:All 42 patients had dcTN with preoperative BNI scores of V and NRS scores of 8e10.Endoscopic visualization enabled the precise identification of neurovascular conflicts,including small and deeply located vessels.Immediately after surgery,90.5%of patients achieved complete pain relief(BNI score of I,NRS score of 0).At the final follow-up,85.7%of patients had complete pain relief.All patients’pain was significantly relieved at immediate after surgery(0 vs.9,p<0.001)and at the final follow-up(0 vs.9,p<0.001),with lower NRS scores.Complications,including vertigo,headache,and transient facial numbness,occurred in 14.4%of patients and were manageable.展开更多
Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),a...Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),and to assess the role of the trigeminal nerve.Methods:Sprague-Dawley(SD)rats were randomly assigned to the sham-operation,model,xiusanzhen,and trigeminal neurotomy groups(n=15 per group).Bilateral common carotid artery ligation was performed to prepare the VD models.Models of trigeminal neurotomy were prepared through the excision of the frontal nerve and infraorbital nerve.Xiusanzhen acupuncture was delivered via electric stimulation.The acupoints selected were bilateral“Yingxiang(LI20)”and“Yintang(EX-HN3)”,and the stimulation parameters were as follows:disperse-dense wave,at a frequency of 2/15HZ and intensity of 1 mA.The course of treatment was once daily,with one course lasting five days,followed by an interval of two days,yielding a total of four courses.Behavioral changes were detected using the Morris water maze,changes in histomorphology in the hippocampal CA1 region were determined with hematoxylin and eosin(HE)staining,and MG activation in the hippocampal CA1 region was detected using immunofluorescence.Results:The escape latency:From days 3 to 5,the escape latency was higher in the model group compared to the sham-operation group(P<0.05),but was lower in the xiusanzhen group compared to the model and trigeminal neurotomy groups(P<0.05).The frequency for platform crossing and swimming distance:both were reduced in the model group compared to the sham-operation group(P<0.01);and were elevated in the xiusanzhen group compared to the model group and trigeminal neurotomy group(P<0.01).Hippocampal pathomorphological changes:In the sham-operation group,the morphological structure and nucleoli were well-defined;in the model group and the trigeminal neurotomy group,cell numbers were reduced and karyopyknosis increased;while in the xiusanzhen group,the cell numbers were elevated and karyopyknosis was reduced compared with the model group.MG:the positive rate was higher in the model group compared to the sham-operation group(P<0.05);lower in the xiusanzhen group compared to the model group(P<0.05);and higher in the trigeminal neurotomy group compared to the xiusanzhen group(P<0.05).Conclusion:Xiusanzhen acupuncture attenuates cognitive impairment in VD rats,inhibits MG activation,and reduces hippocampal tissue damage.Its effects depend on the structural integrity of the trigeminal nerve.展开更多
BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding t...BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.METHODS The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database,Wanfang Data,VIP Database,as well as international databases such as Excerpt Medica Database,Cochrane Library,PubMed,and Web of Science,along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform,ChiCTR,and Clinical Trials up to 1 April 2020.Risk of bias was evaluated using the Cochrane Collaborative Risk Bias tool,primary outcome measures(pain reduction)were analyzed using STATA metaanalysis,outcome measures were analyzed using trial sequential analysis 0.9.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were documented.RESULTS This study analyzed 16 RCTs with a total of 1231 participants.The meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine[standardized mean difference(SMD)=1.47;95%confidence interval(CI):0.99-1.95],although the quality of evidence was deemed to be of extremely low quality.Cumulative meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time[SMD=1.84;95%CI:0.22-3.47].Additionally,the number of adverse events associated with acupuncture was significantly lower compared to carbamazepine.CONCLUSION Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine;however,firm conclusions still require a high-quality,multicenter,large-sample RCT to confirm these findings.展开更多
Oral squamous cell carcinoma(OSCC)associated pain commonly predicts adverse events among patients.This clinical feature indicates the engagement of nociceptors on sensory neurons during the development of malignancy.H...Oral squamous cell carcinoma(OSCC)associated pain commonly predicts adverse events among patients.This clinical feature indicates the engagement of nociceptors on sensory neurons during the development of malignancy.However,it is yet to be determined if targeting oncometabolite-associated nociception processes can hinder OSCC progression.In this study,we reported that nociceptive endings infiltrating both clinical samples and mouse tumor xenografts were associated with poorer clinical outcomes and drove tumor progression in vivo,as evidenced by clinical tissue microarray analysis and murine lingual denervation.We observed that the OSCC microenvironment was characteristic of excessive adenosine due to CD73 upregulation which negatively predicted clinical outcomes in the TCGA-HNSC patient cohort.Notably,such adenosine concentrative OSCC niche was associated with the stimulation of adenosine A2Areceptor(A2AR)on trigeminal ganglia.Antagonism of trigeminal A2AR with a selective A2AR inhibitor SCH58261 resulted in impeded OSCC growth in vivo.We showed that trigeminal A2AR overstimulation in OSCC xenograft did not entail any changes in the transcription level of CGRP in trigeminal ganglia but significantly triggered the release of CGRP,an effect counteracted by SCH58261.We further demonstrated the pro-tumor effect of CGRP by feeding mice with the clinically approved CGRP receptor antagonist rimegepant which inhibited the activation of ERK and YAP.Finally,we diminished the impact of CGRP on OSCC with istradefylline,a clinically available drug that targets neuronal A2AR.Therefore,we established trigeminal A2AR-mediated CGRP release as a promising druggable circuit in OSCC treatment.展开更多
Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility ...Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.展开更多
Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elder...Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elderly patients with recurrent trigeminal neuralgia who visited the Pain Department of our hospital from March 2022 to April 2024.Logistic regression analysis was employed to evaluate the factors influencing psychological distress,based on general patient data,the Distress Thermometer(DT),the Perceived Social Support from Family Scale(PSS-Fa),and the Pitsburgh Sleep Quality Index(PSQI).Results:Among the 126 elderly patients with recurrent trigeminal neuralgia,those with a DT score≥4(72 patients,57.14%)were more prevalent than those with a DT score<4(54 patients,42.86%).The average DT score for all patients was 4.35±1.72.Patients in the DT score≥4 group were older than those in the DT score<4 group(t=4.207,P=0.000),had lower PSS-Fa scores(t=5.925,P=0.000),and had higher PSQI scores(t=17.858,P=0.000).There were no statistically significant differences in gender,marital status,residence area,education level,disease type,or pain location(all P>0.05).Older age and poor sleep quality were identified as independent risk factors for psychological distress in elderly patients with recurrent trigeminal neuralgia(OR=1.258,OR=1.713,both P<0.05),while higher levels of family support were identified as a protective factor(OR=0.581,P=0.025).Conclusion:Elderly patients with recurrent trigeminal neuralgia experience psychological distress,and the degree of severity depends on age,quality of sleep,and level of family support.展开更多
Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN...Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS) and patients’ reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.展开更多
Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad ...Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad to establish a model of orofacial inflammatory pain. The distribution of melatonin re- ceptor 1 and nicotinamide adenine dinucleotide phosphate diaphorase in the caudal spinal trigeminal nucleus and trigeminal ganglion was determined with immunohistochemistry and histo- chemistry. The results show that there are significant differences in melatonin receptor 1 expression and nicotinamide adenine dinucleotide phosphate diaphorase expression in the trigeminal ganglia and caudal spinal nucleus during the early stage of orofacial inflammatory pain. Our findings sug- gest that when melatonin receptor 1 expression in the caudal spinal nucleus is significantly reduced, melatonin＇s regulatory effect on pain is attenuated.展开更多
Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there a...Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, com- pression time or balloon shape, for the procedure. In this study, percutaneous microballoon compression was performed on the rabbit trigeminal ganglion at a mean inflation pressure of 1,005 ＋ 150 mmHg for 2 or 5 minutes. At 1, 7 and 14 days after percutaneous microballoon compression, the large-diameter myelinated nerves displayed axonal swelling, rupture and demy- elination under the electron microscope. Fragmentation of myelin and formation of digestion chambers were more evident after 5 minutes of compression. Image analyzer results showed that the diameter of trigeminal ganglion cells remained unaltered after compression. These experi- mental findings indicate that a 2-minute period of compression can suppress pain transduction. Immunohistochemical staining revealed that vascular endothelial growth factor expression in the ganglion cells and axons was significantly increased 7 days after trigeminal ganglion compression, however, the changes were similar after 2-minute compression and 5-minute compression. The upregulated expression of vascular endothelial growth factor in the ganglion cells after percu- taneous microballoon compression can promote the repair of the injured nerve. These findings suggest that long-term compression is ideal for patients with recurrent trigeminal neuralgia.展开更多
Objective To evaluate the effectiveness of three-dimensional computed tomography （3D-CT） guided radiofi＇equency trigeminal rhizotomy （RF-TR） in treatment of idiopathic trigeminal neuralgia （1TN）. Methods From ...Objective To evaluate the effectiveness of three-dimensional computed tomography （3D-CT） guided radiofi＇equency trigeminal rhizotomy （RF-TR） in treatment of idiopathic trigeminal neuralgia （1TN）. Methods From 1999 to 2001, 18 patients with ITN were treated with percutaneous controlled RF-TR. Intraoperative 3D-CT scanning was performed to guide the trajectory of the puncture. After correction of the needle tip according to the CT scans and stimulation effects, 2 to 5 lesions were made for a duration of 60-90 seconds at a temperature of 60℃ to 75℃ depending on the pain distribution and the age of patient. The needles located in foramen ovale. Pain alleviated immediately with no serious complication in all patients. The patients were followed up for an average of 31.5 months （range 24-41 months）. Acute pain relief was experienced by 17 patients after the procedure, reaching an initial success rate of 94.4%. Early （〈 6 months） pain recurrence was observed in 2 patients （11.1%）, whereas late （〉 6 months） recurrence was reported in 3 patients （16.7%）. Thirteen patients had complete pain control, with no need for medication thereafter. Five cases experienced partial pain relief, but required medication at a lower dose than in the preoperative period. Conclusion 3D-CT foramen ovale locations can raise the successful rate of puncture, enhance the safety, and reduce the incidence rate of complication.展开更多
Objective To observe the differences in therapeutic effects on primary trigeminat neuralgia between contralateral needling technique and routine acupuncture. Methods One hundred and thirty cases were randomly divided ...Objective To observe the differences in therapeutic effects on primary trigeminat neuralgia between contralateral needling technique and routine acupuncture. Methods One hundred and thirty cases were randomly divided into contralateral needling group and routine acupuncture group, 65 cases in each one. In contralateral needling group, contralateral needling technique was adopted on the acupoints on the opposite side corresponding to the affected face in neuralgia. According to the localization of trigeminal neuralgia, the points were selected. For example, for ophthalmologic branch, Yuyao （鱼腰 EX- HN 4） and Touwei （头维 ST 8） were selected as the main point. In routine acupuncture group, the corresponding acupoints were selected on the affected side of the face. The points were same as that in contralateral needling group, Three courses of treatment were required in two groups. The clinical efficacy was evaluated 4 weeks after the end of treatment. Results The total effective rate was 95.4% （62/65） in contralateral needling group, which was superior to that in routine acupuncture group E86.2% （56/65）1 （P〈0. 001）. Conclusion Contralateral needling technique achieves apparently superior effects on primary trigeminal neuralgia compared with routine acupuncture.展开更多
BACKGROUND： Most of the currently available information on purinergic receptors （P2Rs） involved in pain transmission is based on results obtained in dorsal root ganglion or the spinal cord. However, the mechanism o...BACKGROUND： Most of the currently available information on purinergic receptors （P2Rs） involved in pain transmission is based on results obtained in dorsal root ganglion or the spinal cord. However, the mechanism of P2Rs in trigeminal neuralgia remains unclear. OBJECTIVE： To investigate changes in the P2R-mediated calcium signaling pathway in nociceptive trigemJnal ganglion neurons. DESIGN, TIME AND SETTING： In vitro experiments were conducted at the Patch-Clamp Laboratory of Comprehensive Experiment Center of Anhui Medical University, China from September 2008 to June 2009. MATERIALS： Thapsigargin, caffeine, suramin, and adenosine 5＇-triphosphate were purchased from Sigma, USA. METHODS： Using Fura-2-based microfluorimetry, intracellular calcium concentration （[Ca^2＋]i） was measured in freshly isolated adult rat small trigeminal ganglion neurons before and after drug application. MAIN OUTCOME MEASURES： Fluorescent intensities were expressed as the ratio F340/F380 to observe [Ca^2＋]i changes. RESULTS： In normal extracellular solution and Ca^2＋-free solution, application of thapsigargin （1 μmol/L）, a sarcoplasmic reticulum Ca^2＋ pump adenosine 5＇-triphosphate inhibitor, as well as caffeine （20 mmol/L）, a ryanodine receptor agonist, triggered [Ca^2＋]i increase in small trigeminal ganglion neurons. A similar response was induced by application of adenosine 5＇-triphosphate （100 μmol/L）. In Ca^2＋-free conditions, adenosine 5＇-triphosphate-induced [Ca^2＋]i transients in small trigeminal ganglion neurons were inhibited in cells pre-treated with thapsigargin （P 〈 0.01）, but not by caffeine （P 〉 0.05）. In normal, extracellular solution, adenosine 5＇-triphosphate-induced [Ca^2＋]i transients in small trigeminal ganglion neurons were partly inhibited in cells pre-treated with thapsigargin （P 〈 0.05）. CONCLUSION： Inositol-1,4, 5-triphosphate （IP3）- and ryanodine-sensitive Ca^2＋ stores exist in rat nociceptive trigeminal ganglion neurons. Two pathways are involved in the purinoreceptor-mediated [Ca^2＋]i rise observed in nociceptive trigeminal ganglion neurons. One pathway involves the metabotropic P2Y receptors, which are associated with the IP3 sensitive Ca^2＋store, and the second pathway is coupled to ionotropic P2X receptors that induce the Ca^2＋ influx.展开更多
Trigeminal neuropathic pain(TNP)is a significant health problem but the involved mechanism has not been completely elucidated.Toll-like receptors(TLRs)have recently been demonstrated to be expressed in the dorsal root...Trigeminal neuropathic pain(TNP)is a significant health problem but the involved mechanism has not been completely elucidated.Toll-like receptors(TLRs)have recently been demonstrated to be expressed in the dorsal root ganglion and involved in chronic pain.Here,we show that TLR8 was persistently increased in the trigeminal ganglion(TG)neurons in model of TNP induced by partial infraorbital nerve ligation(pIONL).In addition,deletion or knockdown of Tlr8 in the TG attenuated pIONL-induced mechanical allodynia,reduced the activation of ERK and p38-MAPK,and decreased the expression of pro-inflammatory cytokines in the TG.Furthermore,intra-TG injection of the TLR8 agonist VTX-2337 induced pain hypersensitivity.VTX-2337 also increased the intracellular Ca^(2+)concentration,induced the activation of ERK and p38,and increased the expression of pro-inflammatory cytokines in the TG.These data indicate that TLR8 contributes to the maintenance of TNP through increasing MAPK-mediated neuroinflammation.Targeting TLR8 signaling may be effective for the treatment of TNP.展开更多
Objective To investigate the involvement of transient receptor potential vanilloid receptor 1 （TRPV1） in the facial inflammatory pain in relation to thermal hyperalgesia and cold pain sensation. Methods Facial infla...Objective To investigate the involvement of transient receptor potential vanilloid receptor 1 （TRPV1） in the facial inflammatory pain in relation to thermal hyperalgesia and cold pain sensation. Methods Facial inflammatory pain model was developed by subcutaneous injection of turpentine oil （TO） into rat facial area. Head withdrawal thermal latency （HWTL） and head withdrawal cold latency （HWCL） were measured once a day for 21 d after TO treatment using thermal and cold measurement apparatus. The immunohistochemical staining, cell-size frequency analysis and the survey of average optical density （OD） value were used to observe the changes of TRPV1 expression in the neurons of the trigeminal ganglion （TG）, peripheral nerve fibers in the vibrissal pad, and central projection processes in the trigeminal sensory nuclei caudalis （Vc） on day 3, 5, 7, 14, and 21 after TO injection. Results HWTL and HWCL decreased significantly from day 1 to day 14 after TO injection with the lowest value on day 5 and day 3, respectively, and both recovered on day 21. The number of TRPV1-labeled neurons increased remarkably from day 1 to day 14 with a peak on day 7, and returned back to the normal level on day 21. In control rats, only small and medium-sized TG neurons were immunoreactive （IR） to TRPV1, and the TRPV1-IR terminals were abundant in both the vibrissal pad and the Vc. Within 2 weeks of inflammation, the expression of TRPV1 in small and medium-sized TG neurons increased obviously. Also the TRPV1 stained terminals and fibers appeared more frequent and denser in both the vibrissal pad skin and throughout laminae Ⅰ and the outer zone of laminae Ⅱ （Ⅱo） of Vc. Conclusion Facial inflammatory pain could induce hyperalgesia to noxious heat and cold stimuli, and result in increase of the numbers of TRPV1 positive TG neurons and the peripheral and central terminals of TG. These results suggest that the phenotypic changes of TRPV1 expression in small and medium-sized TG neurons and terminals might play an important role in the development and maintenance of TO-induced inflammatory thermal hyperalgesia and cold pain sensation.展开更多
Objective: To explore the pathogenesis of trigeminal neuralgia (TN) and to provide a new target for the drug treatment of TN by studying the expression of tetrodotoxin-resistant hNav1. 8 sodium channel protein in affe...Objective: To explore the pathogenesis of trigeminal neuralgia (TN) and to provide a new target for the drug treatment of TN by studying the expression of tetrodotoxin-resistant hNav1. 8 sodium channel protein in affected nerves of patients with TN. Methods: Twelve affected inferior alveolar nerves were obtained from patients with idiopathic TN, to whom the drug therapy was not effective. As negative control, one nonnal inferior alveolar nerve was obtained from patients who accepted the combined radical neck dissection with glossectomy and mandibulectomy. One muscle sample was obtained as normal control. One dorsal root ganglion from rat was as positive control. These tissues and prepared hNav1. 8 antibody were conducted immunohistochemistry response. Results: hNav1.8 channel protein was expresses in all the 12 specimens of the affected nerves of patients with TN, but not in the muscle sample and the normal inferior alveolar nerve. Conclusion: The abnormal expression of hNav1. 8 channel protein in the affected nerves of patients with TN may play an important role in the pathogenesis of TN.展开更多
With the methods of transganglionic transport of horseradish peroxidase(HRP) combined with postembedding colloidal gold stain immunoelectron microscopy, the shape and synaptic relationship of the trigeminal primary af...With the methods of transganglionic transport of horseradish peroxidase(HRP) combined with postembedding colloidal gold stain immunoelectron microscopy, the shape and synaptic relationship of the trigeminal primary afferent terminals containing substance展开更多
To evaluate the effect of triple puncture on primary trigeminal neuralgia (pTN),64 patients with pTN were randomly assigned to two groups:treatment group and control group.The participants in the treatment group recei...To evaluate the effect of triple puncture on primary trigeminal neuralgia (pTN),64 patients with pTN were randomly assigned to two groups:treatment group and control group.The participants in the treatment group received triple puncture treatment of 6 times per week for 4 weeks,and those in control group were given carbamazepine (300-600 mg per day) for at least 1 month.Before and after treatment,the primary outcomes including the total efficiency rate and the VAS pain scores,and the secondary outcomes including the frequency of pain attack and adverse events were observed.Sixty-two participants finished the study (33 in treatment group and 29 in control group individually).After treatment,the symptoms (mainly pain) of the two groups were alleviated.The total efficiency rate in the treatment group and control group was 90.9% and 75.9% respectively.The VAS pain scores and frequency of pain attack were significantly reduced in the treatment group as compared with the control group (P<0.05).The incidence of adverse events in the treatment group and control group was 9.1% and 24.1% respectively.It can be inferred that triple puncture can effectively improve the quality of life of patients with pTN and has less side effects.展开更多
Experiments were carried out on rats anaesthetized with uraethane. The sponta-neous discharges and nociceptive responses of convergent neurons in the right trigerninal nucleus cau-dalis(TNC) to noxious stimuli at rece...Experiments were carried out on rats anaesthetized with uraethane. The sponta-neous discharges and nociceptive responses of convergent neurons in the right trigerninal nucleus cau-dalis(TNC) to noxious stimuli at receptive field (cheek) were recorded extracellularly with glass mi-cro-electrode. Electroacupuncture (EA ) was applied at bilateral " Xiaguan" (ST 7 on face ) or "Zusanli" (ST 36 on shank) acupoint with Iow (2V) and high (18V) intensity. The noclceptive re-sponse of convergent neurons in TNC could be inhihited by low intensity EA applied at "Xiaguan" butnot "Zusanlil", showing the specificity of acupoints. High intensity EA at either "Xiaguan" or "Zusan-li" also reduced the nociceptive responses, showing the analgesic extensiveness of acupoints. We sug-gest that "the gate of control" mechanism plays a main role in low intensity EA and "diffuse noxiousinhibitory controls" (DNIC) rnechanism does so in high intensity EA.The results suggest that we should pay attention to the location of acupoints,展开更多
Objective:To detect neurovascular compression-induced structural abnormalities of trigeminal nerves(TGN) by diffusion tensor imaging(DTI).Methods:The affected ipsilateral TGN(iTGN) and unaffected contralateral TGN(cTG...Objective:To detect neurovascular compression-induced structural abnormalities of trigeminal nerves(TGN) by diffusion tensor imaging(DTI).Methods:The affected ipsilateral TGN(iTGN) and unaffected contralateral TGN(cTGN) of 20 trifacial neuralgia(TIM) patients as well as the bilateral TGN of 10 normal controls(nTGN) were examined by DTI and 3D high resolution MR] using a 3.0 T MRI scanner.The fractional anisotropy and apparent diffusion coefficieiil(ADC) were determined.Results:Compared with the cTGN and nTGN,the iTGN.had significantly lower fraction of anisotropy(FA),significantly higher ADC.and significantly smaller volume and crosssectional area(P【0.05).Conclusions:The increase in ADC and decrease in FA has a close relationship with morphological changes of TGN,and the DTI could provide valuable diagnostic information on TGN structure forTN patients.展开更多
To investigate the behavioral and biomolecular similarity between neuralgia and depression, a trigeminal neuralgia （TN） mouse model was established by constriction of the infraorbital nerve （CION） to mimic clinica...To investigate the behavioral and biomolecular similarity between neuralgia and depression, a trigeminal neuralgia （TN） mouse model was established by constriction of the infraorbital nerve （CION） to mimic clinical trigeminal neuropathic pain. A mouse learned helplessness （LH） model was developed to investigate inescapable footshock-induced psychiatric disorders like depression in humans. Mass spectrometry was used to assess changes in the biomolecules and signaling pathways in the hip- pocampus from TN or LH mice. TN mice developed not only significant mechanical allodynia but also depressive- like behaviors （mainly behavioral despair） at 2 weeks after CION, similar to LH mice. MS analysis demonstrated common and distinctive protein changes in the hippocampus between groups. Many protein function families （such as cell-to-cell signaling and interaction, and cell assembly and organization,） and signaling pathways （e.g., the Huntington＇s disease pathway） were involved in chronic neuralgia and depression. Together, these results demonstrated that the LH and TN models both develop depressive-like behaviors, and revealed the involvement of manypsychiatric disorder-related biomolecules/pathways in the pathogenesis of TN and LH.展开更多
基金supported by financial assistance from the Zhejiang Provincial Natural Science Foundation of China under Grant No.LY18H160020.
文摘Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evaluates the efficacy of fully endoscopic MVD for dcTN and presents our early experience.Methods:This retrospective study included patients with dcTN who underwent fully endoscopic MVD in the Department of Neurosurgery,the First Affiliated Hospital,Zhejiang University School of Medicine from November 2020 to February 2023.We recorded basic patient clinical information,clinical outcomes,offending vessels,complications,and recurrences,and assessed outcomes via the Barrow Neurological Institute(BNI)pain intensity score and the numeric rating scale(NRS)score.Results:All 42 patients had dcTN with preoperative BNI scores of V and NRS scores of 8e10.Endoscopic visualization enabled the precise identification of neurovascular conflicts,including small and deeply located vessels.Immediately after surgery,90.5%of patients achieved complete pain relief(BNI score of I,NRS score of 0).At the final follow-up,85.7%of patients had complete pain relief.All patients’pain was significantly relieved at immediate after surgery(0 vs.9,p<0.001)and at the final follow-up(0 vs.9,p<0.001),with lower NRS scores.Complications,including vertigo,headache,and transient facial numbness,occurred in 14.4%of patients and were manageable.
基金Supported by The National Natural Science Foundation of China Young Scientists Fund:82004480。
文摘Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),and to assess the role of the trigeminal nerve.Methods:Sprague-Dawley(SD)rats were randomly assigned to the sham-operation,model,xiusanzhen,and trigeminal neurotomy groups(n=15 per group).Bilateral common carotid artery ligation was performed to prepare the VD models.Models of trigeminal neurotomy were prepared through the excision of the frontal nerve and infraorbital nerve.Xiusanzhen acupuncture was delivered via electric stimulation.The acupoints selected were bilateral“Yingxiang(LI20)”and“Yintang(EX-HN3)”,and the stimulation parameters were as follows:disperse-dense wave,at a frequency of 2/15HZ and intensity of 1 mA.The course of treatment was once daily,with one course lasting five days,followed by an interval of two days,yielding a total of four courses.Behavioral changes were detected using the Morris water maze,changes in histomorphology in the hippocampal CA1 region were determined with hematoxylin and eosin(HE)staining,and MG activation in the hippocampal CA1 region was detected using immunofluorescence.Results:The escape latency:From days 3 to 5,the escape latency was higher in the model group compared to the sham-operation group(P<0.05),but was lower in the xiusanzhen group compared to the model and trigeminal neurotomy groups(P<0.05).The frequency for platform crossing and swimming distance:both were reduced in the model group compared to the sham-operation group(P<0.01);and were elevated in the xiusanzhen group compared to the model group and trigeminal neurotomy group(P<0.01).Hippocampal pathomorphological changes:In the sham-operation group,the morphological structure and nucleoli were well-defined;in the model group and the trigeminal neurotomy group,cell numbers were reduced and karyopyknosis increased;while in the xiusanzhen group,the cell numbers were elevated and karyopyknosis was reduced compared with the model group.MG:the positive rate was higher in the model group compared to the sham-operation group(P<0.05);lower in the xiusanzhen group compared to the model group(P<0.05);and higher in the trigeminal neurotomy group compared to the xiusanzhen group(P<0.05).Conclusion:Xiusanzhen acupuncture attenuates cognitive impairment in VD rats,inhibits MG activation,and reduces hippocampal tissue damage.Its effects depend on the structural integrity of the trigeminal nerve.
文摘BACKGROUND In this randomized controlled trial(RCT)comparing current acupuncture with carbamazepine for trigeminal neuralgia,meta-and sequential analyses were utilized.AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.METHODS The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database,Wanfang Data,VIP Database,as well as international databases such as Excerpt Medica Database,Cochrane Library,PubMed,and Web of Science,along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform,ChiCTR,and Clinical Trials up to 1 April 2020.Risk of bias was evaluated using the Cochrane Collaborative Risk Bias tool,primary outcome measures(pain reduction)were analyzed using STATA metaanalysis,outcome measures were analyzed using trial sequential analysis 0.9.5.10 Beta sequential analysis,GRADE was used to assess the evidence,and adverse reactions were documented.RESULTS This study analyzed 16 RCTs with a total of 1231 participants.The meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine[standardized mean difference(SMD)=1.47;95%confidence interval(CI):0.99-1.95],although the quality of evidence was deemed to be of extremely low quality.Cumulative meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time[SMD=1.84;95%CI:0.22-3.47].Additionally,the number of adverse events associated with acupuncture was significantly lower compared to carbamazepine.CONCLUSION Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine;however,firm conclusions still require a high-quality,multicenter,large-sample RCT to confirm these findings.
基金National Natural Science Foundation of China(82170971,82373187and 82002888)Fundamental Research Funds for the Central Universities(YJ201987)+2 种基金Sichuan Science and Technology Program(2021ZYD0090 and 2022YFS0207)Scientific Research Foundation,West China Hospital of Stomatology Sichuan University(QDJF2019-3 and RD-03-202110)CAMS Innovation Fund for Medical Sciences(CIFMS,2019-I2M-5-004)。
文摘Oral squamous cell carcinoma(OSCC)associated pain commonly predicts adverse events among patients.This clinical feature indicates the engagement of nociceptors on sensory neurons during the development of malignancy.However,it is yet to be determined if targeting oncometabolite-associated nociception processes can hinder OSCC progression.In this study,we reported that nociceptive endings infiltrating both clinical samples and mouse tumor xenografts were associated with poorer clinical outcomes and drove tumor progression in vivo,as evidenced by clinical tissue microarray analysis and murine lingual denervation.We observed that the OSCC microenvironment was characteristic of excessive adenosine due to CD73 upregulation which negatively predicted clinical outcomes in the TCGA-HNSC patient cohort.Notably,such adenosine concentrative OSCC niche was associated with the stimulation of adenosine A2Areceptor(A2AR)on trigeminal ganglia.Antagonism of trigeminal A2AR with a selective A2AR inhibitor SCH58261 resulted in impeded OSCC growth in vivo.We showed that trigeminal A2AR overstimulation in OSCC xenograft did not entail any changes in the transcription level of CGRP in trigeminal ganglia but significantly triggered the release of CGRP,an effect counteracted by SCH58261.We further demonstrated the pro-tumor effect of CGRP by feeding mice with the clinically approved CGRP receptor antagonist rimegepant which inhibited the activation of ERK and YAP.Finally,we diminished the impact of CGRP on OSCC with istradefylline,a clinically available drug that targets neuronal A2AR.Therefore,we established trigeminal A2AR-mediated CGRP release as a promising druggable circuit in OSCC treatment.
文摘Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.
文摘Objective:To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors.Methods:A single-center cross-sectional study was conducted on 126 elderly patients with recurrent trigeminal neuralgia who visited the Pain Department of our hospital from March 2022 to April 2024.Logistic regression analysis was employed to evaluate the factors influencing psychological distress,based on general patient data,the Distress Thermometer(DT),the Perceived Social Support from Family Scale(PSS-Fa),and the Pitsburgh Sleep Quality Index(PSQI).Results:Among the 126 elderly patients with recurrent trigeminal neuralgia,those with a DT score≥4(72 patients,57.14%)were more prevalent than those with a DT score<4(54 patients,42.86%).The average DT score for all patients was 4.35±1.72.Patients in the DT score≥4 group were older than those in the DT score<4 group(t=4.207,P=0.000),had lower PSS-Fa scores(t=5.925,P=0.000),and had higher PSQI scores(t=17.858,P=0.000).There were no statistically significant differences in gender,marital status,residence area,education level,disease type,or pain location(all P>0.05).Older age and poor sleep quality were identified as independent risk factors for psychological distress in elderly patients with recurrent trigeminal neuralgia(OR=1.258,OR=1.713,both P<0.05),while higher levels of family support were identified as a protective factor(OR=0.581,P=0.025).Conclusion:Elderly patients with recurrent trigeminal neuralgia experience psychological distress,and the degree of severity depends on age,quality of sleep,and level of family support.
基金supported by a grant from the Beijing Municipal Project of Science and Technology (No.Y0204003040631)
文摘Radiofrequency thermocoagulation(RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS) and patients’ reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.
基金supported by the National Natural Science Foundation of China,No.81271166,81371107the Natural Science Foundation of Guangdong Province in China,No.10451008901006145
文摘Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad to establish a model of orofacial inflammatory pain. The distribution of melatonin re- ceptor 1 and nicotinamide adenine dinucleotide phosphate diaphorase in the caudal spinal trigeminal nucleus and trigeminal ganglion was determined with immunohistochemistry and histo- chemistry. The results show that there are significant differences in melatonin receptor 1 expression and nicotinamide adenine dinucleotide phosphate diaphorase expression in the trigeminal ganglia and caudal spinal nucleus during the early stage of orofacial inflammatory pain. Our findings sug- gest that when melatonin receptor 1 expression in the caudal spinal nucleus is significantly reduced, melatonin＇s regulatory effect on pain is attenuated.
基金supported by a grant from Shengjing Hospital,China Medical University,China,No.201010252
文摘Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, com- pression time or balloon shape, for the procedure. In this study, percutaneous microballoon compression was performed on the rabbit trigeminal ganglion at a mean inflation pressure of 1,005 ＋ 150 mmHg for 2 or 5 minutes. At 1, 7 and 14 days after percutaneous microballoon compression, the large-diameter myelinated nerves displayed axonal swelling, rupture and demy- elination under the electron microscope. Fragmentation of myelin and formation of digestion chambers were more evident after 5 minutes of compression. Image analyzer results showed that the diameter of trigeminal ganglion cells remained unaltered after compression. These experi- mental findings indicate that a 2-minute period of compression can suppress pain transduction. Immunohistochemical staining revealed that vascular endothelial growth factor expression in the ganglion cells and axons was significantly increased 7 days after trigeminal ganglion compression, however, the changes were similar after 2-minute compression and 5-minute compression. The upregulated expression of vascular endothelial growth factor in the ganglion cells after percu- taneous microballoon compression can promote the repair of the injured nerve. These findings suggest that long-term compression is ideal for patients with recurrent trigeminal neuralgia.
文摘Objective To evaluate the effectiveness of three-dimensional computed tomography （3D-CT） guided radiofi＇equency trigeminal rhizotomy （RF-TR） in treatment of idiopathic trigeminal neuralgia （1TN）. Methods From 1999 to 2001, 18 patients with ITN were treated with percutaneous controlled RF-TR. Intraoperative 3D-CT scanning was performed to guide the trajectory of the puncture. After correction of the needle tip according to the CT scans and stimulation effects, 2 to 5 lesions were made for a duration of 60-90 seconds at a temperature of 60℃ to 75℃ depending on the pain distribution and the age of patient. The needles located in foramen ovale. Pain alleviated immediately with no serious complication in all patients. The patients were followed up for an average of 31.5 months （range 24-41 months）. Acute pain relief was experienced by 17 patients after the procedure, reaching an initial success rate of 94.4%. Early （〈 6 months） pain recurrence was observed in 2 patients （11.1%）, whereas late （〉 6 months） recurrence was reported in 3 patients （16.7%）. Thirteen patients had complete pain control, with no need for medication thereafter. Five cases experienced partial pain relief, but required medication at a lower dose than in the preoperative period. Conclusion 3D-CT foramen ovale locations can raise the successful rate of puncture, enhance the safety, and reduce the incidence rate of complication.
文摘Objective To observe the differences in therapeutic effects on primary trigeminat neuralgia between contralateral needling technique and routine acupuncture. Methods One hundred and thirty cases were randomly divided into contralateral needling group and routine acupuncture group, 65 cases in each one. In contralateral needling group, contralateral needling technique was adopted on the acupoints on the opposite side corresponding to the affected face in neuralgia. According to the localization of trigeminal neuralgia, the points were selected. For example, for ophthalmologic branch, Yuyao （鱼腰 EX- HN 4） and Touwei （头维 ST 8） were selected as the main point. In routine acupuncture group, the corresponding acupoints were selected on the affected side of the face. The points were same as that in contralateral needling group, Three courses of treatment were required in two groups. The clinical efficacy was evaluated 4 weeks after the end of treatment. Results The total effective rate was 95.4% （62/65） in contralateral needling group, which was superior to that in routine acupuncture group E86.2% （56/65）1 （P〈0. 001）. Conclusion Contralateral needling technique achieves apparently superior effects on primary trigeminal neuralgia compared with routine acupuncture.
基金the National Natural Science Foundation of China, No.30670694 the Natural Science Foundation of Anhui Province Department of Education in China, No.2006KJ361B+2 种基金 the National Science Fund for Distinguished Young Scholars of Anhui Medical University, No.GJJQ-0801 the Scientific Research Foundation for Doctor of Anhui Medical University, No. XJ2005006the Special Foundation for Young Scientists in Higher Education Institutions of Anhui Province, No.2010SQRL078
文摘BACKGROUND： Most of the currently available information on purinergic receptors （P2Rs） involved in pain transmission is based on results obtained in dorsal root ganglion or the spinal cord. However, the mechanism of P2Rs in trigeminal neuralgia remains unclear. OBJECTIVE： To investigate changes in the P2R-mediated calcium signaling pathway in nociceptive trigemJnal ganglion neurons. DESIGN, TIME AND SETTING： In vitro experiments were conducted at the Patch-Clamp Laboratory of Comprehensive Experiment Center of Anhui Medical University, China from September 2008 to June 2009. MATERIALS： Thapsigargin, caffeine, suramin, and adenosine 5＇-triphosphate were purchased from Sigma, USA. METHODS： Using Fura-2-based microfluorimetry, intracellular calcium concentration （[Ca^2＋]i） was measured in freshly isolated adult rat small trigeminal ganglion neurons before and after drug application. MAIN OUTCOME MEASURES： Fluorescent intensities were expressed as the ratio F340/F380 to observe [Ca^2＋]i changes. RESULTS： In normal extracellular solution and Ca^2＋-free solution, application of thapsigargin （1 μmol/L）, a sarcoplasmic reticulum Ca^2＋ pump adenosine 5＇-triphosphate inhibitor, as well as caffeine （20 mmol/L）, a ryanodine receptor agonist, triggered [Ca^2＋]i increase in small trigeminal ganglion neurons. A similar response was induced by application of adenosine 5＇-triphosphate （100 μmol/L）. In Ca^2＋-free conditions, adenosine 5＇-triphosphate-induced [Ca^2＋]i transients in small trigeminal ganglion neurons were inhibited in cells pre-treated with thapsigargin （P 〈 0.01）, but not by caffeine （P 〉 0.05）. In normal, extracellular solution, adenosine 5＇-triphosphate-induced [Ca^2＋]i transients in small trigeminal ganglion neurons were partly inhibited in cells pre-treated with thapsigargin （P 〈 0.05）. CONCLUSION： Inositol-1,4, 5-triphosphate （IP3）- and ryanodine-sensitive Ca^2＋ stores exist in rat nociceptive trigeminal ganglion neurons. Two pathways are involved in the purinoreceptor-mediated [Ca^2＋]i rise observed in nociceptive trigeminal ganglion neurons. One pathway involves the metabotropic P2Y receptors, which are associated with the IP3 sensitive Ca^2＋store, and the second pathway is coupled to ionotropic P2X receptors that induce the Ca^2＋ influx.
基金the National Natural Science Foundation of China(31970938,31671091,31871064,81571070,and 31700899)the Natural Science Research Program of Jiangsu Province,China(BK20171255 and BK20191448)+1 种基金the Qing Lan Projectthe Innovation and Entrepreneurship Training Program for College Students in Jiangsu Province,China(201810304029Z)。
文摘Trigeminal neuropathic pain(TNP)is a significant health problem but the involved mechanism has not been completely elucidated.Toll-like receptors(TLRs)have recently been demonstrated to be expressed in the dorsal root ganglion and involved in chronic pain.Here,we show that TLR8 was persistently increased in the trigeminal ganglion(TG)neurons in model of TNP induced by partial infraorbital nerve ligation(pIONL).In addition,deletion or knockdown of Tlr8 in the TG attenuated pIONL-induced mechanical allodynia,reduced the activation of ERK and p38-MAPK,and decreased the expression of pro-inflammatory cytokines in the TG.Furthermore,intra-TG injection of the TLR8 agonist VTX-2337 induced pain hypersensitivity.VTX-2337 also increased the intracellular Ca^(2+)concentration,induced the activation of ERK and p38,and increased the expression of pro-inflammatory cytokines in the TG.These data indicate that TLR8 contributes to the maintenance of TNP through increasing MAPK-mediated neuroinflammation.Targeting TLR8 signaling may be effective for the treatment of TNP.
基金supported by the National Natural Science Foundation of China(No.30570629)China-Dutch Joint Research Project(No.05CDP030)
文摘Objective To investigate the involvement of transient receptor potential vanilloid receptor 1 （TRPV1） in the facial inflammatory pain in relation to thermal hyperalgesia and cold pain sensation. Methods Facial inflammatory pain model was developed by subcutaneous injection of turpentine oil （TO） into rat facial area. Head withdrawal thermal latency （HWTL） and head withdrawal cold latency （HWCL） were measured once a day for 21 d after TO treatment using thermal and cold measurement apparatus. The immunohistochemical staining, cell-size frequency analysis and the survey of average optical density （OD） value were used to observe the changes of TRPV1 expression in the neurons of the trigeminal ganglion （TG）, peripheral nerve fibers in the vibrissal pad, and central projection processes in the trigeminal sensory nuclei caudalis （Vc） on day 3, 5, 7, 14, and 21 after TO injection. Results HWTL and HWCL decreased significantly from day 1 to day 14 after TO injection with the lowest value on day 5 and day 3, respectively, and both recovered on day 21. The number of TRPV1-labeled neurons increased remarkably from day 1 to day 14 with a peak on day 7, and returned back to the normal level on day 21. In control rats, only small and medium-sized TG neurons were immunoreactive （IR） to TRPV1, and the TRPV1-IR terminals were abundant in both the vibrissal pad and the Vc. Within 2 weeks of inflammation, the expression of TRPV1 in small and medium-sized TG neurons increased obviously. Also the TRPV1 stained terminals and fibers appeared more frequent and denser in both the vibrissal pad skin and throughout laminae Ⅰ and the outer zone of laminae Ⅱ （Ⅱo） of Vc. Conclusion Facial inflammatory pain could induce hyperalgesia to noxious heat and cold stimuli, and result in increase of the numbers of TRPV1 positive TG neurons and the peripheral and central terminals of TG. These results suggest that the phenotypic changes of TRPV1 expression in small and medium-sized TG neurons and terminals might play an important role in the development and maintenance of TO-induced inflammatory thermal hyperalgesia and cold pain sensation.
文摘Objective: To explore the pathogenesis of trigeminal neuralgia (TN) and to provide a new target for the drug treatment of TN by studying the expression of tetrodotoxin-resistant hNav1. 8 sodium channel protein in affected nerves of patients with TN. Methods: Twelve affected inferior alveolar nerves were obtained from patients with idiopathic TN, to whom the drug therapy was not effective. As negative control, one nonnal inferior alveolar nerve was obtained from patients who accepted the combined radical neck dissection with glossectomy and mandibulectomy. One muscle sample was obtained as normal control. One dorsal root ganglion from rat was as positive control. These tissues and prepared hNav1. 8 antibody were conducted immunohistochemistry response. Results: hNav1.8 channel protein was expresses in all the 12 specimens of the affected nerves of patients with TN, but not in the muscle sample and the normal inferior alveolar nerve. Conclusion: The abnormal expression of hNav1. 8 channel protein in the affected nerves of patients with TN may play an important role in the pathogenesis of TN.
文摘With the methods of transganglionic transport of horseradish peroxidase(HRP) combined with postembedding colloidal gold stain immunoelectron microscopy, the shape and synaptic relationship of the trigeminal primary afferent terminals containing substance
文摘To evaluate the effect of triple puncture on primary trigeminal neuralgia (pTN),64 patients with pTN were randomly assigned to two groups:treatment group and control group.The participants in the treatment group received triple puncture treatment of 6 times per week for 4 weeks,and those in control group were given carbamazepine (300-600 mg per day) for at least 1 month.Before and after treatment,the primary outcomes including the total efficiency rate and the VAS pain scores,and the secondary outcomes including the frequency of pain attack and adverse events were observed.Sixty-two participants finished the study (33 in treatment group and 29 in control group individually).After treatment,the symptoms (mainly pain) of the two groups were alleviated.The total efficiency rate in the treatment group and control group was 90.9% and 75.9% respectively.The VAS pain scores and frequency of pain attack were significantly reduced in the treatment group as compared with the control group (P<0.05).The incidence of adverse events in the treatment group and control group was 9.1% and 24.1% respectively.It can be inferred that triple puncture can effectively improve the quality of life of patients with pTN and has less side effects.
文摘Experiments were carried out on rats anaesthetized with uraethane. The sponta-neous discharges and nociceptive responses of convergent neurons in the right trigerninal nucleus cau-dalis(TNC) to noxious stimuli at receptive field (cheek) were recorded extracellularly with glass mi-cro-electrode. Electroacupuncture (EA ) was applied at bilateral " Xiaguan" (ST 7 on face ) or "Zusanli" (ST 36 on shank) acupoint with Iow (2V) and high (18V) intensity. The noclceptive re-sponse of convergent neurons in TNC could be inhihited by low intensity EA applied at "Xiaguan" butnot "Zusanlil", showing the specificity of acupoints. High intensity EA at either "Xiaguan" or "Zusan-li" also reduced the nociceptive responses, showing the analgesic extensiveness of acupoints. We sug-gest that "the gate of control" mechanism plays a main role in low intensity EA and "diffuse noxiousinhibitory controls" (DNIC) rnechanism does so in high intensity EA.The results suggest that we should pay attention to the location of acupoints,
基金Supported by the Science Foundation of Haikou Health Bureau (2010-SWY-13-058)Haikou Science Technology Information Bureau(2009- 049-1)
文摘Objective:To detect neurovascular compression-induced structural abnormalities of trigeminal nerves(TGN) by diffusion tensor imaging(DTI).Methods:The affected ipsilateral TGN(iTGN) and unaffected contralateral TGN(cTGN) of 20 trifacial neuralgia(TIM) patients as well as the bilateral TGN of 10 normal controls(nTGN) were examined by DTI and 3D high resolution MR] using a 3.0 T MRI scanner.The fractional anisotropy and apparent diffusion coefficieiil(ADC) were determined.Results:Compared with the cTGN and nTGN,the iTGN.had significantly lower fraction of anisotropy(FA),significantly higher ADC.and significantly smaller volume and crosssectional area(P【0.05).Conclusions:The increase in ADC and decrease in FA has a close relationship with morphological changes of TGN,and the DTI could provide valuable diagnostic information on TGN structure forTN patients.
基金supported by the National Natural Science Foundation of China(31421091,81471130,31371123 and 31420103903)a Development Project of Shanghai Peak Disciplines Integrated Chinese and Western Medicine,China
文摘To investigate the behavioral and biomolecular similarity between neuralgia and depression, a trigeminal neuralgia （TN） mouse model was established by constriction of the infraorbital nerve （CION） to mimic clinical trigeminal neuropathic pain. A mouse learned helplessness （LH） model was developed to investigate inescapable footshock-induced psychiatric disorders like depression in humans. Mass spectrometry was used to assess changes in the biomolecules and signaling pathways in the hip- pocampus from TN or LH mice. TN mice developed not only significant mechanical allodynia but also depressive- like behaviors （mainly behavioral despair） at 2 weeks after CION, similar to LH mice. MS analysis demonstrated common and distinctive protein changes in the hippocampus between groups. Many protein function families （such as cell-to-cell signaling and interaction, and cell assembly and organization,） and signaling pathways （e.g., the Huntington＇s disease pathway） were involved in chronic neuralgia and depression. Together, these results demonstrated that the LH and TN models both develop depressive-like behaviors, and revealed the involvement of manypsychiatric disorder-related biomolecules/pathways in the pathogenesis of TN and LH.
