Hypothalamic activation discriminates painful and non-painful initiation of the trigeminal autonomic reflex – an fMRI study
| Autor: | Arne May, Maike Möller, Jan Mehnert |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Hypothalamus Pain Proof of Concept Study Discrimination Learning 03 medical and health sciences 0302 clinical medicine Physical Stimulation Reflex medicine Humans Trigeminal Nerve Trigeminal autonomic reflex Pain Measurement 030304 developmental biology 0303 health sciences business.industry Cluster headache General Medicine medicine.disease Magnetic Resonance Imaging Healthy Volunteers Tears Female Neurology (clinical) Brainstem business Neuroscience 030217 neurology & neurosurgery |
| Zdroj: | Cephalalgia. 40:79-87 |
| ISSN: | 1468-2982 0333-1024 |
| Popis: | Background The role of the trigeminal autonomic reflex in headache syndromes, such as cluster headache, is undisputed but sparsely investigated. The aim of the present study was therefore, to identify neural correlates that play a role in the initiation of the trigeminal autonomic reflex. We further aimed to discriminate between components of the reflex that are involved in nociceptive compared to non-nociceptive processing. Methods Kinetic Oscillation Stimulation (KOS) in the left nostril was applied in order to provoke autonomic symptoms (e.g. lacrimation) via the trigeminal autonomic reflex in 26 healthy participants using functional magnetic resonance imaging. Unpleasantness and painfulness were assessed on a visual analog scale (VAS), in order to assess the quality of the stimulus (e.g. pain or no pain). Results During non-painful activation, specific regions involved in the trigeminal autonomic reflex became activated, including several brainstem nuclei but also cerebellar and bilateral insular regions. However, when the input leading to activation of the trigeminal autonomic reflex was perceived as painful, activation of the anterior hypothalamus, the locus coeruleus (LC), the ventral posteriomedial nucleus of the thalamus (VPM), as well as an activation of ipsilateral insular regions, was observed. Conclusion Our results suggest the anterior hypothalamus, besides the thalamus and specific brain stem regions, play a significant role in networks that mediate autonomic output (e.g. lacrimation) following trigeminal input, but only if the trigeminal system is activated by a stimulus comprising a painful component. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|