trigeminal

三叉神经
  • 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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  • 文章类型: Journal Article
    简介三叉神经鞘瘤手术在功能恢复和肿瘤切除方面显示出显着改善。在放射外科时代,对于放射外科治疗范围之外的肿瘤,需要对这些结局进行表征。我们提出了一系列大于3厘米的三叉神经鞘瘤,使用的手术方法,和结果,重点是在具有放射外科设施的高容量中心的功能恢复。方法将2012年1月至2021年5月连续3cm以上的三叉神经鞘瘤病例纳入本组。手术方法,神经系统的结果,和切除程度通过术前/术后磁共振成像客观确定。结果共发现83例(>3cm),脑神经症状(第五常见)是最常见的。23%的病例由于继发性视神经萎缩而失明,而18%的病例具有长束运动症状,这表明我们系列中的肿瘤负担。75.9%的病例实现了放射学总切除。结论大体积神经鞘瘤表现为颅神经受累,可能需要广泛的颅底入路。尽管总切除率较低,但需要优先考虑功能结果,并且可以实现。除了缓解三叉神经症状外,保留听力和面部还应该是切除的目标,同时减少额外的发病率。
    Introduction  Trigeminal schwannoma surgery has shown a remarkable improvement in functional recovery and tumor resection. In the era of radiosurgery, these outcomes need to be characterized for tumors which are outside the realm of being treated with radiosurgery. We present a series of trigeminal schwannomas larger than 3 cm, surgical approaches used, and outcomes with an emphasis on functional recovery in a high-volume center with radiosurgery facilities. Method  All consecutive cases of trigeminal schwannoma from January 2012 to May 2021 which were more than 3 cm in size and underwent microsurgery were included in this series. The surgical approach, neurological outcomes, and extent of resection were defined objectively with pre/postoperative magnetic resonance imaging. Results  A total of 83 such cases (>3 cm) were found, with cranial nerve symptoms (5th most common) being the commonest. Twenty three percent cases had blindness due to secondary optic atrophy and eighteen percent had long tract motor symptoms signifying the tumor burden in our series. Radiological gross total excision was achieved in 75.9% cases. Conclusion  Large-volume schwannomas present with cranial nerve involvement and may need extensive skull base approaches. Functional outcomes need to be prioritized and can be achieved albeit with lesser gross resection rates. Hearing and facial preservation in addition to relief of trigeminal symptoms should be the goal of resection with minimal additional morbidity.
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  • 文章类型: Case Reports
    原发性颅内脑膜黑素瘤罕见。诊断原发性脑膜黑素瘤主要涉及通过临床和放射学手段进行综合评估。该评估应包括详细的皮肤和眼科检查。任何可疑病变必须进行活检和显微镜检查。这不仅对于区分原发性颅内黑色素瘤与其他脑肿瘤至关重要,而且对于排除原发性皮肤或非皮肤黑色素瘤的潜在来源的转移至关重要。手术被认为是治疗的主要手段。尽管黑色素瘤通常被认为是放射性和化学耐药性肿瘤,辅助放疗和化疗在它们的管理中仍然起着至关重要的作用。原发性脑膜黑色素瘤的治疗前景在不断发展,正在进行的研究旨在改善这种具有挑战性的疾病患者的预后。
    Primary intracranial meningeal melanomas are rare. Diagnosing primary meningeal melanomas mostly involves comprehensive assessment through clinical and radiological means. This evaluation should encompass a detailed dermal and ophthalmic examination. Any suspicious lesion must be biopsied and examined microscopically. This is crucial not only to differentiate primary intracranial melanoma from other brain tumors but also to rule out metastases from potential sources of primary cutaneous or non-cutaneous melanomas. Surgery is considered the mainstay of treatment. Despite melanomas being generally considered radio- and chemo-resistant tumors, adjuvant radiotherapy and chemotherapy still play a crucial role in their management. The treatment landscape for primary meningeal melanoma is continually evolving, with ongoing research aiming to improve outcomes for patients with this challenging disease.
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