PMID- 30055103
OWN - NLM
STAT- MEDLINE
DCOM- 20190418
LR  - 20190418
IS  - 1532-2149 (Electronic)
IS  - 1090-3801 (Linking)
VI  - 23
IP  - 1
DP  - 2019 Jan
TI  - Reduced inhibition in brainstem circuits in classical trigeminal neuralgia.
PG  - 142-149
LID - 10.1002/ejp.1293 [doi]
AB  - OBJECTIVE: We hypothesized that prepulse modulation (PPM) would be altered in 
      trigeminal neuralgia (TN) if suprasegmental inhibitory network involvement was 
      present and tested our hypothesis in a group of patients with classical TN. 
      METHODS: The study enrolled nine consecutive patients with classical TN and 14 
      healthy subjects. Diagnosis and classification followed the International 
      Classification of Headache Disorders-third edition (beta version). The blink 
      reflex (BR) and BR-PPM were recorded. Ipsilateral recordings were made after 
      stimulating each trigeminal nerve in the patient group whereas right-sided 
      recordings were performed after stimulating the right trigeminal nerve in the 
      healthy subjects. A conditioning electrical stimulus was applied to the 
      ipsilateral median nerve at interstimulus intervals (ISIs) of 50 and 100 ms 
      before the test stimulus to the supraorbital nerve. RESULTS: The unconditioned BR 
      recordings were similar in all groups. In the healthy subjects, the prepulse 
      stimulus resulted in a reduced R2 magnitude (p = 0.000, Friedman's test) and 
      longer R2 latency (p = 0.008, Friedman's test) at ISIs of 50 and 100 ms in 
      comparison with unconditioned recordings. The R2 latency differed significantly 
      between the unconditioned recordings and the ISI of 100 ms. In the patients with 
      TN, no significant change was observed on either the symptomatic or asymptomatic 
      sides. CONCLUSIONS: There is a bilateral prepulse inhibition deficit in TN, even 
      on the asymptomatic side. Our findings provide electrophysiological evidence for 
      suprasegmental changes and loss of filtering activity at the brainstem in level 
      TN.
CI  - (c) 2018 European Pain Federation - EFIC(R).
FAU - Gunduz, A
AU  - Gunduz A
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Uygunoglu, U
AU  - Uygunoglu U
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Uluduz, D
AU  - Uluduz D
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Saip, S
AU  - Saip S
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Siva, A
AU  - Siva A
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Goksan, B
AU  - Goksan B
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
FAU - Kiziltan, M E
AU  - Kiziltan ME
AD  - Department of Neurology, Cerrahpasa Medical School, Istanbul University, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20180813
PL  - England
TA  - Eur J Pain
JT  - European journal of pain (London, England)
JID - 9801774
SB  - IM
MH  - Adult
MH  - *Blinking
MH  - Brain Stem/*physiopathology
MH  - Case-Control Studies
MH  - Electric Stimulation
MH  - Female
MH  - Humans
MH  - Male
MH  - Median Nerve
MH  - Middle Aged
MH  - *Prepulse Inhibition
MH  - Reflex
MH  - Trigeminal Nerve/*physiopathology
MH  - Trigeminal Neuralgia/*physiopathology
EDAT- 2018/07/29 06:00
MHDA- 2019/04/19 06:00
CRDT- 2018/07/29 06:00
PHST- 2018/06/09 00:00 [accepted]
PHST- 2018/07/29 06:00 [pubmed]
PHST- 2019/04/19 06:00 [medline]
PHST- 2018/07/29 06:00 [entrez]
AID - 10.1002/ejp.1293 [doi]
PST - ppublish
SO  - Eur J Pain. 2019 Jan;23(1):142-149. doi: 10.1002/ejp.1293. Epub 2018 Aug 13.