Open AccessAltered somatosensory processing in trigeminal neuralgia
Author(s) -
Blatow Maria,
Nennig Ernst,
Sarpaczki Elise,
Reinhardt Julia,
Schlieter Martin,
Herweh Christian,
Rasche Dirk,
Tronnier Volker M.,
Sartor Klaus,
Stippich Christoph
Publication year - 2009
Publication title -
human brain mapping
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.005
H-Index - 191
eISSN - 1097-0193
pISSN - 1065-9471
DOI - 10.1002/hbm.20773
Subject(s) - somatosensory system , secondary somatosensory cortex , trigeminal neuralgia , trigeminal nerve , neuroscience , somatosensory evoked potential , stimulation , functional magnetic resonance imaging , psychology , sensory system , sensory stimulation therapy , stimulus (psychology) , medicine , anesthesia , psychotherapist
Trigeminal neuralgia (TN) is a pain state characterized by intermittent unilateral pain attacks in one or several facial areas innervated by the trigeminal nerve. The somatosensory cortex is heavily involved in the perception of sensory features of pain, but it is also the primary target for thalamic input of nonpainful somatosensory information. Thus, pain and somatosensory processing are accomplished in overlapping cortical structures raising the question whether pain states are associated with alteration of somatosensory function itself. To test this hypothesis, we used functional magnetic resonance imaging to assess activation of primary (SI) and secondary (SII) somatosensory cortices upon nonpainful tactile stimulation of lips and fingers in 18 patients with TN and 10 patients with TN relieved from pain after successful neurosurgical intervention in comparison with 13 healthy subjects. We found that SI and SII activations in patients did neither depend on the affected side of TN nor differ between operated and nonoperated patients. However, SI and SII activations, but not thalamic activations, were significantly reduced in patients as compared to controls. These differences were most prominent for finger stimulation, an area not associated with TN. For lip stimulation SI and SII activations were reduced in patients with TN on the contra‐ but not on the ipsilateral side to the stimulus. These findings suggest a general reduction of SI and SII processing in patients with TN, indicating a long‐term modulation of somatosensory function and pointing to an attempt of cortical adaptation to potentially painful stimuli. Hum Brain Mapp, 2009. © 2009 Wiley‐Liss, Inc.