A new trigemino-nociceptive stimulation model for event-related fMRI
A new trigemino-nociceptive stimulation model for event-related fMRI
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DOI：
10.1111/j.1468-2982.2009.01968.x
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发表时间：
2010-04-01
期刊：
影响因子：
4.9
通讯作者：
May, A.
中科院分区：
文献类型：
--
作者：
Stankewitz, A.;Voit, H. L.;May, A.
人类三叉神经伤害性处理的功能成像为头面部疼痛疾病中疼痛处理的改变提供了有意义的见解。虽然功能性磁共振成像（fMRI）提供了高的时间和空间分辨率，但大多数研究都是用放射性配体-正电子发射断层扫描进行的，因为fMRI需要非磁刺激设备和快速开关条件。我们开发了一种新的三叉神经疼痛刺激的方法，可以使用功能磁共振成像的事件相关设计内实现，旨在检测增加血氧水平依赖（BOLD）信号作为三叉神经疼痛处理的替代标记。使用嗅觉仪，20名健康志愿者接受鼻内标准化三叉神经伤害性刺激（氨气）以及嗅觉（玫瑰气味）和无气味的控制刺激（空气吹）。成像显示，在已知参与疼痛处理的皮层和皮层下脑区中，对三叉神经伤害性刺激的强有力的BOLD反应。聚焦于三叉神经疼痛通路，在三叉神经入口区的脑干区域中观察到双侧显著激活，这与三叉神经主核一致。此外，增加的信号变化，可以检测到同侧在解剖定位的三叉神经节和双侧的头端延髓，这可能是代表三叉神经脊束核。然而，脑干区域参与内源性疼痛控制系统，接近这一解剖定位，如中缝核，必须加以讨论。我们的研究结果表明，映射三叉神经痛处理功能磁共振成像与这种非侵入性的实验设计是可行的，能够唤起特定的激活三叉神经伤害性系统。这种方法将提供一个理想的机会，研究三叉神经疼痛系统的健康和病理条件，如特发性头痛疾病。
Functional imaging of human trigemino-nociceptive processing provides meaningful insights into altered pain processing in head and face pain diseases. Although functional magnetic resonance imaging (fMRI) offers high temporal and spatial resolution, most studies available were done with radioligand-positron emission tomography, as fMRI requires non-magnetic stimulus equipment and fast on-off conditions. We developed a new approach for painful stimulation of the trigeminal nerve that can be implemented within an event-related design using fMRI and aimed to detect increased blood-oxygen-level-dependent (BOLD) signals as surrogate markers of trigeminal pain processing. Using an olfactometer, 20 healthy volunteers received intranasally standardized trigeminal nociceptive stimuli (ammonia gas) as well as olfactory (rose odour) and odourless control stimuli (air puffs). Imaging revealed robust BOLD responses to the trigeminal nociceptive stimulation in cortical and subcortical brain areas known to be involved in pain processing. Focusing on the trigeminal pain pathway, significant activations were observed bilaterally in brainstem areas at the trigeminal nerve entry zone, which are agreeable with the principal trigeminal nuclei. Furthermore, increased signal changes could be detected ipsilaterally at anatomical localization of the trigeminal ganglion and bilaterally in the rostral medulla, which probably represents the spinal trigeminal nuclei. However, brainstem areas involved in the endogenous pain control system that are close to this anatomical localization, such as raphe nuclei, have to be discussed. Our findings suggest that mapping trigeminal pain processing using fMRI with this non-invasive experimental design is feasible and capable of evoking specific activations in the trigeminal nociceptive system. This method will provide an ideal opportunity to study the trigeminal pain system in both health and pathological conditions such as idiopathic headache disorders.