Microstructural abnormalities of the trigeminal nerve correlate with pain severity and concomitant emotional dysfunctions in idiopathic trigeminal neuralgia: A randomized, prospective, double-blind study

Wang, Yuan; Li, Dan; Bao, Faxiu; Guo, Chenguang; Ma, Siddiqui; Zhang, Ming

doi:10.1016/j.mri.2015.11.013

Cited by 25 publications

(23 citation statements)

References 28 publications

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“…In contrast to our hypothesis, we found that the overall volume and cross-sectional area of the trigeminal nerve was not different in migraineurs compared with controls. This is unexpected as previous neuroimaging studies, including our own, have revealed increased or decreased trigeminal nerve volumes and cross-sectional areas in various orofacial pain conditions (2)(3)(4)(5)25). Interestingly, the chronic orofacial pain conditions with reported changes in nerve volume are neuropathic in nature, whilst we have previously found that in individuals with the non-neuropathic chronic orofacial pain condition, painful temporomandibular disorder, the trigeminal nerve root entry zone displayed no difference in volume, crosssectional area or diffusivity (5).…”

Section: Trigeminal Nerve Diffusion Analysismentioning

confidence: 55%

Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance imaging

Mungoven

Meylakh

Marciszewski

et al. 2020

Preprint

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Background: There is histological evidence of microstructural changes in the zygomaticotemporal branch of the trigeminal nerve in migraineurs. This raises the possibility that altered trigeminal nerve properties contribute to migraine pathophysiology. Whilst it is not possible to explore the anatomy of small trigeminal nerve branches it is possible to explore the anatomy of the trigeminal root entry zone using magnetic resonance imaging in humans. The aim of this investigation is to assess the microstructure of the trigeminal nerve in vivo to determine if nerve alterations occur in individuals with episodic migraine. Methods: In 39 migraineurs and 39 matched controls, T1-weighted anatomical images were used to calculate the volume (mm3) and maximal cross-sectional area of the trigeminal nerve root entry zone; diffusion tensor images were used to calculate fractional anisotropy, mean diffusion, axial diffusion and radial diffusion. Results: There were significant differences between the left and right nerve of controls and migraineurs with respect to volume and not cross-sectional area. Migraineurs displayed reduced axial diffusion in the right nerve compared to the left nerve and reduced fractional anisotropy in the left nerve compared to left controls. Furthermore, although there were no differences in mean diffusion or radial diffusion, regional analysis of the nerve revealed significantly greater radial diffusion in the rostral portion of the left trigeminal nerve in migraineurs compared with controls. Conclusions: Migraine pathophysiology is associated with microstructural abnormalities within the trigeminal nerve that are consistent with histological evidence of altered myelin and/or organization. These peripheral nerve changes may provide further insight into migraine pathophysiology and enable a greater understanding for targeted treatments of pain alleviation.

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Section: Trigeminal Nerve Diffusion Analysismentioning

confidence: 55%

Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance imaging

Mungoven

Meylakh

Marciszewski

et al. 2020

Preprint

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“…Pain was identified as a psychological stress 30 and, vice versa, stress is a factor that causes and maintains pain intensity 29 . Several studies have shown morphological as well as functional changes in both neuralgic 1,3,[5][6][7][8] and stress states [11][12][13][14] . We noticed that latencies at the neuralgic side were shorter as a result of the hyper-excitability of dysfunctional nerves.…”

Section: Discussionmentioning

confidence: 99%

“…Demyelination may give an increase to electrical hyper excitability, spontaneous and triggered ectopic impulses and cross excitation among neighboring afferents 1,3,5 . Atrophy of the trigeminal nerve 6,7 and reduced volume of gray matter 1,8 are also seen.…”

Section: Introductionmentioning

confidence: 99%

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Salivary alpha-amylase and tooth pulp evoked potentials in paroxysmal trigeminal neuralgia patients

Vukovic¹,

Lazić

Nikolic³

et al. 2021

VOJNOSANIT PREGL

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Introduction / Aim. The sudden and excruciating pain that characterizes paroxysmal trigeminal neuralgia (PTN) has a negative effect on wellbeing of the affected individuals, causing psychological distress. Salivary alpha amylase (sAA) level represents an objective assessment of physical, physiological and psychological stress. Evoked potentials (EPs) can reflect nerve function and evaluate a functional aspect of the trigeminal nerve conduction. The aim of this study was to analyze possible modifications in painful impulses conduction related to sAA level by registering tooth pulp EP in PTN patients. Methods. Ten PTN patients and twelve healthy subjects participated in the study. Activity of sAA was measured using Nipro Salivary Amylase Monitor. To record EP response, dental pulp of vital teeth was electrically stimulated through intact enamel. For stimulation and impulse registration we used Xltek Protektor 32 system, software EPWorks, version 5.0. Results. The results obtained in PTN patients showed a higher number of waves and significantly shorter latencies and lower amplitudes N2-P2 and N3-P3 at the neuralgic side compared to the healthy side of the same patient, as well as to the controls (p<0.05). Also, latencies were significantly shorter in patients with higher sAA levels than in those with normal sAA levels (p<0.05). Late latencies (N2 and P2) at the healthy side in patients with higher sAA levels were significantly shorter compared to patients whose sAA levels were normal (p<0.05). Conclusion. This study showed that psychical stress associated with PTN probably further increased hyper-excitability and conduction velocity of the affected nerves. Moreover, it seems that anticipation of stressful pain even increases conduction velocity of unaffected nerves at the thalamo-cortical level in PTN patients. However, in healthy individuals, stress itself had no influence on painful impulses conduction.

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“…Light touch was defined as touch by the examiner without feeling any bone, while deep touch was defined by touch with pressure until the underlying bone could be palpated. The behavior item on the Hamilton anxiety scale was used to determine the psychologic aspect of the patient's anxiety which was based on the findings of fidgeting, restlessness or pacing, hand tremor, a furrowed brow, a streamed face, sighing or rapid respiration, facial pallor, and/or swallowing. The rating was as follows: 0, not present; 1, mild prevalence; 2, moderate prevalence; 3, severe prevalence; and 4, very severe prevalence in the patient.…”

Section: Methodsmentioning

confidence: 99%

Intra‐arterial Modulation of the Trigeminal Nerve Ganglion in Patients with Refractory Trigeminal Neuralgia

Qureshi

Saleem

Jadhav

et al. 2017

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: Nerves and nerve ganglions are supplied by segmental arteries and the vasa nervorum, but the intra-arterial route has not been used for diagnostic or therapeutic purposes. We present the results of intra-arterial delivery of medication for modulating trigeminal nerve ganglion function in patients with refractory trigeminal neuralgia. METHODS: We administered intra-arterial lidocaine in doses up to 50 mg in the middle meningeal artery territory adjacent to the arterial branch that supplies the trigeminal nerve ganglion. We performed electrophysiologic monitoring to serially assess the latency and amplitude of R1 and R2 responses in the blink reflex before and concurrent with each incremental dose of lidocaine. Clinical outcome assessment included a 10-point numeric rating, 4-point severity grading, and the pain-free time interval pre-and post-treatment. RESULTS: Intra-arterial lidocaine was administered to three patients with trigeminal neuralgia (35-year-old woman, 57-yearold man, and 34-year-old woman). In all patients, there was a latency prolongation and amplitude reduction of R1 or R2 responses or both which was evident after 5-10 mg of lidocaine administration; a more pronounced effect was seen with increasing doses. The second and third patients reported improvement in pain severity on all scales with pain-free intervals of 5 and 3 days, respectively. There was improvement in facial hyperalgesia in all three patients in all dermatomes. All three patients' symptoms had returned to baseline severity 1 month later. CONCLUSIONS:We found that modulation of trigeminal nerve activity via the intra-arterial route is possible based on consistent intraprocedural electrophysiologic suppression and short-term clinical improvement in patients with refractory trigeminal neuralgia.

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Microstructural abnormalities of the trigeminal nerve correlate with pain severity and concomitant emotional dysfunctions in idiopathic trigeminal neuralgia: A randomized, prospective, double-blind study

Cited by 25 publications

References 28 publications

Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance imaging

Microstructural changes in the trigeminal nerve of patients with episodic migraine assessed using magnetic resonance imaging

Salivary alpha-amylase and tooth pulp evoked potentials in paroxysmal trigeminal neuralgia patients

Intra‐arterial Modulation of the Trigeminal Nerve Ganglion in Patients with Refractory Trigeminal Neuralgia

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