Trigeminal

三叉神经
  • 文章类型: Journal Article
    尽管舌头的触觉敏锐度很高,但舌头机械感觉的神经基础仍然很大程度上是神秘的。灵敏度,以及与道德上重要的功能的相关性。我们研究了来自三叉神经节的舌传入的末端形态和触觉反应。真菌状乳头,舌头上的味蕾结构,被多个Piezo2+三叉神经传入神经支配,而单个三叉神经传入分枝成多个相邻的丝状乳头。来自三叉神经节的体内单单位记录显示,舌侧低阈值机械感受器(LTMR)具有独特的触觉特性,从中等适应(IA)到快速适应(RA)。这些LTMR的感受野大多小于0.1mm2,集中在舌尖,类似于真菌状乳头的分布。我们的结果表明,真菌状乳头是机械感觉结构,并提出了一个简单的模型,该模型将舌头中触觉感觉神经元的功能和解剖特性联系起来。
    The neural basis of tongue mechanosensation remains largely mysterious despite the tongue\'s high tactile acuity, sensitivity, and relevance to ethologically important functions. We studied terminal morphologies and tactile responses of lingual afferents from the trigeminal ganglion. Fungiform papillae, the taste-bud-holding structures in the tongue, were convergently innervated by multiple Piezo2+ trigeminal afferents, whereas single trigeminal afferents branched into multiple adjacent filiform papillae. In vivo single-unit recordings from the trigeminal ganglion revealed lingual low-threshold mechanoreceptors (LTMRs) with distinct tactile properties ranging from intermediately adapting (IA) to rapidly adapting (RA). The receptive fields of these LTMRs were mostly less than 0.1 mm2 and concentrated at the tip of the tongue, resembling the distribution of fungiform papillae. Our results indicate that fungiform papillae are mechanosensory structures and suggest a simple model that links functional and anatomical properties of tactile sensory neurons in the tongue.
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  • 文章类型: Journal Article
    背景:口服第二代gepant可有效治疗偏头痛。第三代gepantzavegepant的鼻内给药可能具有其他益处,包括快速起效,但目前尚不清楚这在多大程度上具有临床相关性。
    方法:我们研究了zavegepant对降钙素基因相关肽(CGRP)诱导的人脑膜中动脉松弛的影响。此外,我们通过结合临床和基础研究数据,将gepants的药效学和药代动力学联系起来。
    结果:我们显示10nMzavegepant有效拮抗对CGRP的功能反应。我们还表明,所有gepant在其治疗血浆浓度下都能有效抑制对CGRP的功能反应。
    结论:在治疗性全身血浆浓度下,zavegepant抑制CGRP诱导的舒张的预测效力相对较低,这可能表明通过鼻内给药局部递送至三叉神经血管系统的相关性。这种方法可能对不同的患者群体有额外的好处,包括超重患者。
    BACKGROUND: Orally administered second-generation gepants are effective for the treatment of migraine. The intranasal administration of the third-generation gepant zavegepant might have additional benefits including a rapid onset of action, but it is not clear yet to which extent this has clinical relevance.
    METHODS: We examined the effect of zavegepant on the relaxations induced by calcitonin gene-related peptide (CGRP) in human isolated middle meningeal arteries. Furthermore, we connected the pharmacodynamics and pharmacokinetics of gepants by combining data from clinical and basic research.
    RESULTS: We showed that 10 nM zavegepant potently antagonized the functional response to CGRP. We also showed that all gepants are effective at inhibiting functional responses to CGRP at their therapeutic plasma concentrations.
    CONCLUSIONS: The relatively low predicted potency of zavegepant to inhibit CGRP-induced relaxation at therapeutic systemic plasma concentrations may point to the relevance of local delivery to the trigeminovascular system through intranasal administration. This approach may have additional benefits for various groups of patients, including overweight patients.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fpain.2024.1374929。].
    [This corrects the article DOI: 10.3389/fpain.2024.1374929.].
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  • 文章类型: Journal Article
    本文综述的关于表观遗传学在慢性颅面神经性疼痛中的作用的论文提供的信息至关重要,因为在慢性神经性疼痛的发展和维持过程中的表观遗传失调尚未得到很好的表征。尤其是颅面疼痛.我们已经注意到,所报道的基因表达变化根据神经损伤模型和所报道的样品收集时间点而变化。在我们的慢性神经性疼痛模型中,在10周的真正慢性时间点,所检查的基因功能分组包括那些可能有助于抗炎的基因,神经修复/再生,和伤害性。讨论了用表观遗传调节剂LMK235治疗后改变的基因。所有这些差异都是开发诊断靶向疗法的关键,并且可能是提供治疗的时机。这里重申了对受伤后时间相关性的强调。
    The information provided from the papers reviewed here about the role of epigenetics in chronic craniofacial neuropathic pain is critically important because epigenetic dysregulation during the development and maintenance of chronic neuropathic pain is not yet well characterized, particularly for craniofacial pain. We have noted that gene expression changes reported vary depending on the nerve injury model and the reported sample collection time point. At a truly chronic timepoint of 10 weeks in our model of chronic neuropathic pain, functional groupings of genes examined include those potentially contributing to anti-inflammation, nerve repair/regeneration, and nociception. Genes altered after treatment with the epigenetic modulator LMK235 are discussed. All of these differentials are key in working toward the development of diagnosis-targeted therapeutics and likely for the timing of when the treatment is provided. The emphasis on the relevance of time post-injury is reiterated here.
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  • 文章类型: Journal Article
    背景:小儿头痛是一个日益严重的医学问题,对儿童的生活质量产生不利影响,学业成绩,和社会功能。与健康的同龄人相比,原发性头痛的儿童表现出增强的感觉敏感性。然而,缺乏包括多模式感觉敏感性评估在内的全面调查。这项研究旨在比较原发性头痛儿童与健康同龄人在多个感觉领域的感觉敏感性。
    方法:该研究包括172名6至17岁的参与者(M=13.09,SD=3.02岁;120名女孩)。这80名参与者是偏头痛患者,23名紧张型头痛患者,69人是健康对照。获得以下感官测量:机械检测阈值(MDT),机械性疼痛阈值(MPT),机械性疼痛敏感性(MPS),经皮神经电刺激(TENS)的检测和疼痛阈值,嗅觉和鼻内三叉神经检测阈值,和气味识别能力。通过一系列Kruskal-Wallis测试比较了两组之间的感觉敏感性。二项回归模型用于比较感觉敏感性测量在将参与者分为患者和健康对照时的相对效用。以及偏头痛和紧张型头痛患者。
    结果:偏头痛患者前臂的MPT比紧张型头痛患者和健康对照组的MPT低。偏头痛患者的MPS高于健康对照组。所有头痛患者的TENS检测阈值较低,嗅觉敏感性较高。健康对照显示鼻内三叉神经敏感性增加。MPS中的分数,TENS,嗅觉阈值和三叉神经阈值可显著预测原发性头痛的存在。此外,MPT分数,嗅觉和三叉神经阈值是头痛类型的阳性预测因子。
    结论:患有原发性头痛的儿童表现出与健康对照组不同的感觉特征。获得的结果表明存在增加的总体,原发性头痛儿童的多模态敏感性,什么可能对日常功能产生负面影响,并导致进一步的疼痛慢性化。
    背景:该研究已在德国临床试验注册中心(DRKS)DRKS00021062注册。
    BACKGROUND: Pediatric headache is an increasing medical problem that has adverse effects on children\'s quality of life, academic performance, and social functioning. Children with primary headaches exhibit enhanced sensory sensitivity compared to their healthy peers. However, comprehensive investigations including multimodal sensory sensitivity assessment are lacking. This study aimed to compare sensory sensitivity of children with primary headaches with their healthy peers across multiple sensory domains.
    METHODS: The study included 172 participants aged 6 to 17 years (M = 13.09, SD = 3.02 years; 120 girls). Of these 80 participants were patients with migraine, 23 were patients with tension-type headache, and 69 were healthy controls. The following sensory measures were obtained: Mechanical Detection Threshold (MDT), Mechanical Pain Threshold (MPT), Mechanical Pain Sensitivity (MPS), detection and pain threshold for Transcutaneous Electrical Nerve Stimulation (TENS), olfactory and intranasal trigeminal detection threshold, and odor identification ability. Sensory sensitivity was compared between groups with a series of Kruskal-Wallis tests. Binomial regression models were used to compare the relative utility of sensory sensitivity measures in classifying participants into patients and healthy controls, as well as into patients with migraine and tension-type headache.
    RESULTS: Patients with migraine had lower MPT measured at the forearm than patients with tension-type headaches and healthy controls. MPS was higher in patients with migraine than in healthy controls. All patients with headaches had lower detection threshold of TENS and higher olfactory sensitivity. Healthy controls showed increased intranasal trigeminal sensitivity. Scores in MPS, TENS, and olfactory and trigeminal thresholds were significantly predicting presence of primary headaches. Additionally, scores in MPT, olfactory and trigeminal threshold were positive predictors of type of headache.
    CONCLUSIONS: Children with primary headaches exhibit different sensory profiles than healthy controls. The obtained results suggest presence of increased overall, multimodal sensitivity in children with primary headaches, what may negatively impact daily functioning and contribute to further pain chronification.
    BACKGROUND: The study was registered in the German Registry of Clinical Trials (DRKS) DRKS00021062.
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  • 文章类型: Journal Article
    背景虽然药物治疗是治疗的主要手段,在三叉神经痛(TN),患者对它没有反应,使他们成为消融或非消融程序的候选人。目的本研究的目的是比较微血管减压术(MVD)和射频(RF)热凝术治疗影响下颌和上颌分区的TN的结果。材料与方法回顾性分析了40例患有难治性经典TN的患者的数据,这些患者影响上颌或下颌分区或两者。20例患者接受了三叉神经MVD手术;20例接受了三叉神经上颌或下颌分区或两者的射频消融。结果在MVD中,16例患者(80%)获得了总体成功的结果,而失败的是4例患者(20%),其中3例患者结局一般,1例患者结局较差.而在射频治疗中,17例患者(85%)获得了总体成功结果,而失败的是3例患者(15%),其中2例患者结局一般,1例患者结局较差.两组之间的结果没有显着差异(p值0.806)。结论MVD和RF消融是解决包括下颌骨和上颌骨分区的TN的安全有效的手术选择。长期随访研究表明,MVD始终产生有利的结果,将其确立为首选的主要手术技术,除非患者的一般健康状况和特定需求禁忌。
    Background  Although medical treatment is the mainstay of therapy, in trigeminal neuralgia (TN), patients failing to respond to it make them candidates to ablative or nonablative procedures. Objective  The aim of this study was to compare the outcome of Microvascular decompression (MVD) and radiofrequency (RF) thermocoagulation in the management of TN affecting the mandibular and maxillary divisions. Materials and Methods  Retrospective analysis of the data of 40 patients suffering from intractable classical TN affecting the maxillary or mandibular divisions or both was carried out. Twenty patients were operated upon by MVD of the trigeminal nerve; and 20 had RF ablation of the maxillary or mandibular divisions of the trigeminal nerve or both. Results  In MVD the overall successful outcome was achieved in 16 patients (80%), while the failure was in 4 patients (20%) of which 3 had a fair outcome and 1 patient had a poor outcome. Whereas in RF the overall successful outcome was achieved in 17 patients (85%), while the failure was in 3 patients (15%) of which 2 had a fair outcome and 1 patient had a poor outcome. Outcome was insignificantly different between both groups ( p -value 0.806). Conclusion  MVD and RF ablation represent safe and efficacious surgical choices for addressing TN that encompasses both the mandibular and maxillary divisions. Long-term follow-up studies demonstrate that MVD consistently yields favorable outcomes, establishing it as the preferred primary surgical technique, unless contraindicated by the patient\'s general health and specific needs.
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  • 文章类型: Journal Article
    背景:由于缺乏数据以及自我报告和客观研究结果之间的不一致,孕妇的化学感觉功能远未得到充分理解。
    方法:在本研究中,孕妇和非孕妇(npregned=14,nnnon-pregned=13),我们测量了脑电图衍生的电生理反应测量,并支持心理物理嗅觉和三叉神经测试。
    结果:结果表明,孕妇中与嗅觉事件相关的P1、N1和P2成分的电位幅度或潜伏期保持不变。根据这些发现,孕妇和非孕妇的心理物理嗅觉测试没有差异.然而,与非孕妇对照相比,孕妇对三叉神经刺激的敏感性较低,这也反映在对三叉神经刺激的电生理反应中。
    结论:看似违反直觉,我们的研究结果表明化学体感反应的“平坦化”。怀孕期间发生的心理过程,例如,由于压力反应减弱而导致的对气味的社会情感感知的变化,可以为这些结果提供背景。总的来说,目前的结果表明,在测量的嗅觉功能方面,非孕妇和孕妇之间没有重大差异,尽管孕妇的化学感官功能似乎有所下降。
    BACKGROUND: Chemosensory function in pregnant women is far from being fully understood due to the lack of data and inconsistencies between the results of self-reports and objective studies.
    METHODS: In the present study in pregnant and non-pregnant women (npregnant = 14, nnon-pregnant = 13), we measured EEG-derived electrophysiological response measures supported by psychophysical olfactory and trigeminal tests.
    RESULTS: Results indicate that the olfactory event-related potential amplitudes or latencies of the P1, N1, and P2 components remain unchanged in pregnant women. In accordance with these findings, no difference was observed between pregnant and non-pregnant women in psychophysical olfactory tests. However, pregnant women displayed a lower degree of sensitivity to trigeminal stimuli compared to non-pregnant controls, which was also reflected in the electrophysiological responses to trigeminal stimuli.
    CONCLUSIONS: Counterintuitive as they may seem, our findings demonstrate a \"flattening\" of chemosomatosensory responses. Psychological processes occurring during pregnancy, such as changes in socioemotional perception of odors resulting from the diminished stress response, may provide a background to these results. Overall, the present results indicate the absence of major differences between non-pregnant and pregnant women in terms of measured olfactory function though chemosomatosensory function of the pregnant women appears to be decreased.
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  • 文章类型: Journal Article
    目的:位于Meckel洞穴(MC)内的肿瘤构成了重大的手术挑战。尽管已经描述了进入这个复杂区域的几个走廊,近年来出现了内镜经翼样入路(ETPA)和内镜经眶上眼睑入路(ETOA),作为传统显微手术经颅入路(MTA)的可行替代方案。迄今为止,关于考虑内镜辅助MC入路的手术系列文献有限.
    方法:我们对2015年至2022年间在我们机构治疗的原发性MC肿瘤患者进行了回顾性分析,特别是那些通过术中内窥镜潜水技术(EDT)辅助的ETPA治疗的患者。使用干预前和干预后的放射学图像和手术视频评估病变的切除程度。此外,对ETPA进行了文献综述.
    结果:本系列包括7例受4例三叉神经鞘瘤影响的患者,1个良性脊索细胞瘤,皮样囊肿1例,间充质肿瘤1例。在71%的案例中,三叉神经痛是目前的症状。除一例外,所有病例均观察到术后临床改善。值得注意的是,85.7%的患者实现了全切除或接近全切除(NTR),其余病例接受次全切除术(STR)。术中无明显并发症发生,在平均41个月的随访期内未观察到复发.
    结论:在选定的病例中,ETPA为位于MC内的病变提供了直接安全的路径.这种方法避免了与ETOA或MTA相关的并发症和限制。此外,EDT的使用减少了对关键神经血管结构的操纵,提高ETPA的疗效。
    OBJECTIVE: Tumors located within the Meckel\'s cave (MC) pose a significant surgical challenge. Although several corridors to access this complex region have been described, the endoscopic transpterygoid approach (ETPA) and the endoscopic transorbital superior eyelid approach (ETOA) have emerged in recent years, as viable alternatives to traditional microsurgical transcranial approaches (MTA). To date, there is a limited literature on surgical series considering endoscopic-assisted approaches to the MC.
    METHODS: We conducted a retrospective analysis of patients with primary MC tumors treated at our Institution between 2015 and 2022, specifically those managed via the ETPA assisted by intraoperative Endoscopic Diving Technique (EDT). Lesion resection extent was evaluated using pre- and post-intervention radiological images and surgical videos. Moreover, a literature review on ETPA was performed.
    RESULTS: This series comprises 7 patients affected by 4 trigeminal schwannomas, 1 benign notochordal cell tumor, 1 dermoid cyst and 1 mesenchymal tumor. In 71 % of cases, trigeminal neuralgia was the presenting symptom. Post-operative clinical improvement was observed in all but one case. Notably, 85.7 % of patients achieved total or near-total resection (NTR), with the remaining case undergoing subtotal resection (STR). No significant intraoperative complications occurred, and no recurrences were observed during the mean follow-up period of 41 months.
    CONCLUSIONS: In selected cases, the ETPA offers a direct and safe path to lesions located into the MC. This approach circumvents complications and constraints associated with ETOA or MTA. Moreover, the use of the EDT reduces manipulation of critical neurovascular structures, enhancing the efficacy of the ETPA.
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  • 文章类型: Journal Article
    野生火箭的两个品种(Diplotaxistenuifolia),cv.丹佛和Marte,进行了风味相关成分的化学测定,感官描述性分析,并通过消费者测试来衡量喜好。消费者对火箭叶进行了评估,既可以是单一成分,也可以是由一卷bresaola和GranaPadano奶酪形成的配方。感官分析表明,Marte的特征是更强烈的苦味,热,和辛辣的,这对应于更高的总GSL含量,主要是由于较高水平的二聚体4-巯基丁基GSL。根据他们的喜好得分确定了五个消费者集群。当品尝火箭叶作为单一成分时,三个集群对温和的品种表现出更高的喜好,一个集群显示出相反的偏好,虽然风味属性,如苦涩和炎热,似乎是喜欢的主要驱动因素。当在配方中评估火箭叶时,在两个品种之间不再发现喜好差异。因此,因为火箭叶通常作为配方的一部分与其他成分一起食用,而不是作为单一成分食用,在评估消费者偏好时,不应忽视产品消费方式的影响。
    Two cultivars of wild rocket (Diplotaxis tenuifolia), cv. Denver and Marte, were subjected to chemical determination of flavour-related constituents, sensory descriptive analysis, and measurement of liking by consumer test. Consumers evaluated rocket leaves both as a single ingredient and in a recipe formed by a roll of bresaola with also Grana Padano cheese. Sensory analyses showed that Marte was characterized by a more intense bitterness, hotness, and pungency, which corresponded to a higher total GSL content, mainly due to a higher level of dimeric 4-mercaptobutyl GSL. Five clusters of consumers were identified based on their liking scores. When tasting rocket leaves as a single ingredient, three clusters showed a higher liking for the milder cultivar, one cluster showed an opposite preference, while flavour attributes, such as bitterness and hotness, appeared as the main drivers of liking. Differences in liking were no longer found between the two cultivars when rocket leaves were evaluated in the recipe. Therefore, as rocket leaves are generally consumed as a part of a recipe with other ingredients instead of as a single ingredient, in the assessment of consumer preferences, it should not be neglected the influence of the way in which the product is consumed.
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  • 文章类型: Journal Article
    颞下颌关节(TMJ)由骨骼组成,软骨,韧带,以及相关的咀嚼肌肉和肌腱协调以使哺乳动物咀嚼。TMJ受三叉神经(CNV)支配,包含运动和体感神经元的轴突。躯体感觉包括触觉,温度,本体感受,和疼痛,使哺乳动物能够识别和反应刺激生存。TMJ的躯体感觉神经支配仍然不明确。TMJ(TMD)的病因和表现多种多样。一些与TMD相关的已知症状包括面部,肩膀,或颈部疼痛,下巴弹出或咔嗒声,头痛,牙痛,还有耳鸣.TMD的急性或慢性疼痛源于体感伤害感受器的激活。TMD的治疗可能涉及非处方药和处方药,非手术治疗,和手术治疗。在许多情况下,治疗只能暂时缓解包括疼痛在内的症状。我们建议,定义颞下颌关节及其相关组织的感觉神经支配,特别关注外周神经支配对慢性疼痛发展的贡献,可以提供对关节疼痛起源的见解,并促进改进的镇痛药和治疗TMD的发展。
    The temporomandibular joint (TMJ) consists of bone, cartilage, ligaments, and associated masticatory muscles and tendons that coordinate to enable mastication in mammals. The TMJ is innervated by the trigeminal nerve (CNV), containing axons of motor and somatosensory neurons. Somatosensation includes touch, temperature, proprioception, and pain that enables mammals to recognize and react to stimuli for survival. The somatosensory innervation of the TMJ remains poorly defined. Disorders of the TMJ (TMD) are of diverse etiology and presentation. Some known symptoms associated with TMD include facial, shoulder, or neck pain, jaw popping or clicking, headaches, toothaches, and tinnitus. Acute or chronic pain in TMD stems from the activation of somatosensory nociceptors. Treatment of TMD may involve over- the-counter and prescription medication, nonsurgical treatments, and surgical treatments. In many cases, treatment achieves only a temporary relief of symptoms including pain. We suggest that defining the sensory innervation of the temporomandibular joint and its associated tissues with a specific focus on the contribution of peripheral innervation to the development of chronic pain could provide insights into the origins of joint pain and facilitate the development of improved analgesics and treatments for TMD.
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