Anatomy of Trigeminal Neuromodulation Targets: From Periphery to the Brain.

Q2 Medicine Progress in neurological surgery Pub Date : 2020-01-01 Epub Date: 2020-10-06 DOI:10.1159/000511257
Eduardo Goellner, Carlos Eduardo Rocha
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引用次数: 6

Abstract

The trigeminal nerve complex is a very important and somewhat unique component of the nervous system. It is responsible for the sensory signals that arise from the most part of the face, mouth, nose, meninges, and facial muscles, and also for the motor commands carried to the masticatory muscles. These signals travel through a very complex set of structures: dermal receptors, trigeminal branches, Gasserian ganglion, central nuclei, and thalamus, finally reaching the cerebral cortex. Other neural structures participate, directly or indirectly, in the transmission and modulation of the signals, especially the nociceptive ones; these include vagus nerve, sphenopalatine ganglion, occipital nerves, cervical spinal cord, periaqueductal gray matter, hypothalamus, and motor cortex. But not all stimuli transmitted through the trigeminal system are perceivable. There is a constant selection and modulation of the signals, with either suppression or potentiation of the impulses. As a result, either normal sensory perceptions are elicited or erratic painful sensations are created. Electrical neuromodulation refers to adjustable manipulation of the central or peripheral pain pathways using electrical current for the purpose of reversible modification of the function of the nociceptive system through the use of implantable devices. Here, we discuss not only the distal components, the nerve itself, but also the sensory receptors and the main central connections of the brain, paying attention to the possible neuromodulation targets.

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三叉神经调节靶点解剖:从外周到大脑。
三叉神经复合体是神经系统中非常重要且有些独特的组成部分。它负责从面部、嘴、鼻子、脑膜和面部肌肉的大部分产生的感觉信号,也负责向咀嚼肌发出运动命令。这些信号经过一组非常复杂的结构:皮肤受体、三叉神经分支、加塞利亚神经节、中央核和丘脑,最后到达大脑皮层。其他神经结构直接或间接地参与信号的传递和调制,特别是伤害性信号;包括迷走神经、蝶腭神经节、枕神经、颈脊髓、导水管周围灰质、下丘脑和运动皮层。但并不是所有通过三叉神经系统传递的刺激都是可感知的。有一个恒定的选择和调制的信号,或抑制或增强脉冲。结果,要么唤起正常的感官知觉,要么产生不稳定的痛苦感觉。电神经调节是指通过使用可植入装置,利用电流对中枢或外周疼痛通路进行可调节的操作,目的是可逆地改变伤害感觉系统的功能。在这里,我们不仅讨论远端成分,神经本身,而且还讨论感觉受体和大脑的主要中枢连接,并关注可能的神经调节目标。
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期刊介绍: Published since 1966, this series has become universally recognized as the most significant group of books serving neurological surgeons. Volumes feature contributions from distinguished international surgeons, who brilliantly review the literature from the perspective of their own personal experience. The result is a series of works providing critical distillations of developments of central importance to the theory and practice of neurological surgery.
期刊最新文献
Neuromodulation for Facial Pain Peripheral Nerve Stimulation for Facial Pain Using Conventional Devices: Indications and Results. Sphenopalatine Ganglion Stimulation for Chronic Headache Syndromes. Transcranial Direct Current Stimulation in the Treatment of Facial Pain. Transcutaneous Electrical Nerve Stimulation for Facial Pain.
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