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1.
Int J Mol Sci ; 22(13)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34281164

RESUMO

Chronic orofacial pain conditions can be particularly difficult to diagnose and treat because of their complexity and limited understanding of the mechanisms underlying their aetiology and pathogenesis. Furthermore, there is considerable variability between individuals in their susceptibility to risk factors predisposing them to the development and maintenance of chronic pain as well as in their expression of chronic pain features such as allodynia, hyperalgesia and extraterritorial sensory spread. The variability suggests that genetic as well as environmental factors may contribute to the development and maintenance of chronic orofacial pain. This article reviews these features of chronic orofacial pain, and outlines findings from studies in animal models of the behavioural characteristics and underlying mechanisms related to the development and maintenance of chronic orofacial pain and trigeminal neuropathic pain in particular. The review also considers the role of environmental and especially genetic factors in these models, focussing on findings of differences between animal strains in the features and underlying mechanisms of chronic pain. These findings are not only relevant to understanding underlying mechanisms and the variability between patients in the development, expression and maintenance of chronic orofacial pain, but also underscore the importance for considering the strain of the animal to model and explore chronic orofacial pain processes.


Assuntos
Dor Facial/etiologia , Dor Facial/genética , Dor Facial/fisiopatologia , Animais , Dor Crônica/metabolismo , Modelos Animais de Doenças , Interação Gene-Ambiente , Humanos , Hiperalgesia/metabolismo , Neuralgia/metabolismo , Gânglio Trigeminal/metabolismo
2.
Sci Rep ; 11(1): 14231, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244555

RESUMO

Even though it has been well documented that stress can lead to the development of sleep disorders and the intensification of pain, their relationships have not been fully understood. The present study was aimed at investigating the effects of predictable chronic mild stress (PCMS) on sleep-wake states and pain threshold, using the PCMS rearing conditions of mesh wire (MW) and water (W) for 21 days. Exposure to PCMS decreased the amount of non-rapid eye movement (NREM) sleep during the dark phase. Moreover, the chronicity of PCMS decreased slow-wave activity (SWA) during NREM sleep in the MW and W groups in both the light and dark phases. Mechanical and aversively hot thermal hyperalgesia were more intensified in the PCMS groups than the control. Higher plasma corticosterone levels were seen in mice subjected to PCMS, whereas TNF-α expression was found higher in the hypothalamus in the W and the trigeminal ganglion in the MW group. The W group had higher expression levels of IL-6 in the thalamus as well. The PCMS paradigm decreased SWA and may have intensified mechanical and thermal hyperalgesia. The current study also suggests that rearing under PCMS may cause impaired sleep quality and heightened pain sensation to painful mechanical and aversively hot thermal stimuli.


Assuntos
Dor Facial/fisiopatologia , Locomoção/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Animais , Corticosterona/sangue , Eletroencefalografia , Dor Facial/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Dor/sangue , Dor/fisiopatologia , Limiar da Dor , Reação em Cadeia da Polimerase em Tempo Real , Privação do Sono/sangue , Privação do Sono/fisiopatologia , Transtornos do Sono-Vigília/sangue , Sono REM/fisiologia , Vigília/fisiologia
3.
Int J Mol Sci ; 22(10)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069553

RESUMO

Orofacial pain is a universal predicament, afflicting millions of individuals worldwide. Research on the molecular mechanisms of orofacial pain has predominately focused on the role of neurons underlying nociception. However, aside from neural mechanisms, non-neuronal cells, such as Schwann cells and satellite ganglion cells in the peripheral nervous system, and microglia and astrocytes in the central nervous system, are important players in both peripheral and central processing of pain in the orofacial region. This review highlights recent molecular and cellular findings of the glia involvement and glia-neuron interactions in four common orofacial pain conditions such as headache, dental pulp injury, temporomandibular joint dysfunction/inflammation, and head and neck cancer. We will discuss the remaining questions and future directions on glial involvement in these four orofacial pain conditions.


Assuntos
Dor Facial/metabolismo , Dor Facial/fisiopatologia , Neuroglia/fisiologia , Animais , Dor Facial/terapia , Neoplasias de Cabeça e Pescoço/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Inflamação/fisiopatologia , Microglia/fisiologia , Neurônios/fisiologia , Nociceptividade/fisiologia , Gânglio Trigeminal/fisiologia
4.
Curr Pain Headache Rep ; 25(5): 31, 2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33761012

RESUMO

PURPOSE OF REVIEW: Though first bite syndrome is well known in surgical settings, it is not commonly included in the differential for sharp paroxysmal facial pain in the neurology literature. This paper will highlight the clinical features and relevant anatomy of first bite syndrome, with the goal of helping clinicians differentiate this from other similar facial pain disorders. RECENT FINDINGS: First bite syndrome is severe sharp or cramping pain in the parotid region occurring with the first bite of each meal and improving with subsequent bites. Pathophysiology has been attributed to imbalanced sympathetic/parasympathetic innervation of the parotid gland. This is seen most typically in the post-surgical setting following surgery in the parotid or parapharyngeal region, but neoplastic etiologies have also been reported. It is common for patients to present with concurrent great auricular neuropathy and/or Horner's syndrome. Evidence regarding treatment is limited to case reports/series, however, botulinum toxin injections and neuropathic medicines have been helpful in select cases. It is critical for clinicians to be able to differentiate first bite syndrome from other paroxysmal facial pain. To help with this, we have proposed diagnostic criteria for clinical assessment. Patients often improve gradually over time, but symptomatic treatment with botulinum toxin or neuropathic medicine may be required.


Assuntos
Dor Facial/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Inibidores da Liberação da Acetilcolina/uso terapêutico , Amitriptilina/análogos & derivados , Amitriptilina/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Toxinas Botulínicas/uso terapêutico , Tumor do Corpo Carotídeo/cirurgia , Dor Facial/tratamento farmacológico , Dor Facial/etiologia , Dor Facial/fisiopatologia , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/cirurgia , Síndrome de Horner/complicações , Humanos , Relaxantes Musculares Centrais/uso terapêutico , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Espaço Parafaríngeo , Glândula Parótida/inervação , Neoplasias Parotídeas/complicações , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Neoplasias Tonsilares/cirurgia
5.
Biomed Res Int ; 2021: 6666680, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33564681

RESUMO

Patient education is important in the treatment of temporomandibular disorder (TMD), but little is known about its effect on oral behaviors. We aimed to determine the dominant oral behaviours in patients with TMD and assess the impact of education on such behaviours. Between July 2018 and April 2019, 54 patients diagnosed with TMD according to DC/TMD were recruited. They received physical therapy and were provided education on TMD and offered a list of recommendations for improving their oral behaviours. The patient education process usually lasted for 10-20 min. Of these patients, 48 were reexamined at the outpatient clinic, 3-9 months posttreatment. We recorded the Oral Behaviour Checklist (OBC) score, maximum painless mouth opening (mm), visual analogue scale (VAS) score for pain, and Jaw Functional Limitation Scale (JFLS) score pre- and posttreatment. Wilcoxon signed rank test and paired sample t-test were used for statistical analysis. Results showed that the most dominant oral behaviours included "putting pressure on the jaw" (59.3%); "chewing food on one side" (46.3%); "pressing, touching, or holding teeth together at times other than eating" (33.3%); and "eating between meals" (33.3%). Posttreatment, the patients reported a decrease in "chewing gum" (P = 0.002), "leaning with the hand on the jaw" (P = 0.013), "chewing food on one side" (P ≤ 0.001), and "eating between meals" (P = 0.007), but this change was not significant in subgroups with a follow-up interval of 9 months. We also observed a significant improvement in the maximum painless mouth opening (P ≤ 0.001), JFLS score (P ≤ 0.001), and VAS score (P ≤ 0.001) for pain, posttreatment. In conclusion, patient education can facilitate management of oral behaviours and should be targeted towards specific oral behaviours.


Assuntos
Dor Facial/terapia , Modalidades de Fisioterapia/psicologia , Transtornos da Articulação Temporomandibular/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Dor Facial/fisiopatologia , Dor Facial/psicologia , Feminino , Humanos , Arcada Osseodentária/fisiopatologia , Masculino , Pessoa de Meia-Idade , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/psicologia , Adulto Jovem
6.
Pain Res Manag ; 2021: 6674102, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628354

RESUMO

Objective: First bite syndrome (FBS) is a condition in which the first bite of each meal causes parotid pain. Etiologies of FBS include prior surgery of the upper cervical region and, rarely, head and neck tumors. Idiopathic FBS rarely presents in patients without a history of surgery or evidence of an underlying tumor. Idiopathic FBS may be categorized into two subtypes: that in patients with diabetes and that in patients without diabetes. Idiopathic FBS in patients without diabetes may be overlooked or misdiagnosed because the condition has been described only in a few case reports. We aimed to identify the clinical and pain-related characteristics of idiopathic FBS in patients without diabetes. Methods: We retrospectively analyzed the clinical data of five patients without diabetes who were diagnosed with idiopathic FBS in our department between January 2010 and December 2016. Results: Four of the five patients were female, and the overall median age was 52 years (range: 13-61). All patients immediately experienced parotid pain upon tasting food without chewing. Addition of an acidic solution to the ipsilateral posterior third of the tongue evoked parotid pain. The median degree of pain intensity and interference with eating due to pain was 9 (range: 3-10) and 9 (range: 5-10) on a numerical rating scale of 0-10, respectively. Idiopathic FBS was bilateral in two patients. Two patients had tenderness on mild pressure over the affected parotid region. Two patients presented with ipsilateral idiopathic Horner's syndrome. Conclusions: Our findings indicate that the characteristics of idiopathic FBS in patients without diabetes are largely consistent with those previously reported in postoperative FBS, supporting the notion that idiopathic FBS is a subtype of FBS. Thus, it is necessary to consider idiopathic FBS during the evaluation of facial pain triggered at the beginning of a meal.


Assuntos
Dor Facial/fisiopatologia , Glândula Parótida/fisiopatologia , Paladar/fisiologia , Adolescente , Adulto , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/patologia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome , Adulto Jovem
7.
Cient. dent. (Ed. impr.) ; 18(1): 29-33, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-201768

RESUMO

INTRODUCCIÓN: La mucositis oral es una lesión dolorosa que tiene lugar en la mucosa de la cavidad oral, normalmente su etiología se encuentra asociada a tratamientos farmacológicos en pacientes oncológicos. Se presenta como úlceras bien delimitadas cuya sintomatología dolorosa supone en ocasiones la suspensión del tratamiento oncológico o la alimentación por vía parenteral, siendo por tanto un efecto adverso importante, marcando el devenir en este tipo de terapias contra el cáncer. OBJETIVO: El objetivo del presente artículo es poner en relieve cómo se produce el dolor en esta patología que acontece en la mucosa de la cavidad oral. DISCUSIÓN: La mucositis oral se va a presentar tras una cascada de eventos biológicos que implican diferentes procesos moleculares tras el tratamiento con quimioterapia o radioterapia. El dolor en la mucositis oral puede poseer un componente inflamatorio y también un componente neuropático. En su fisiopatología, el dolor va a estar mediado por diferentes familias de receptores y factores. CONCLUSIÓN: La mucositis oral presenta un gran componente doloroso asociado, en el que cobran especial protagonismo en su aparición, las familias de los receptores y factores TRP, ET-1, TNF y ROS, entre otros. El conocimiento de la patogénesis del dolor en esta patología permitirá desarrollar terapéuticas contra el dolor en estudios futuros


INTRODUCTION: Oral mucositis is a painful lesion that occurs in the mucosa of the oral cavity. Its aetiology is usually associated with drug treatments in cancer patients. It presents as well-defined ulcers whose painful symptoms sometimes lead to the suspension of cancer treatment or parenteral nutrition. They therefore represent a significant adverse effect that marks the future in this type of cancer therapy. OBJECTIVE: The objective of this article is to highlight how pain occurs in this pathology that takes place in the mucosa of the oral cavity. DISCUSSION: Oral mucositis will occur following a cascade of biological events involving different molecular processes following treatment with chemotherapy or radiotherapy. Pain in oral mucositis may have an inflammatory component as well as a neuropathic component. In its pathophysiology, pain will be mediated by different families of receptors and factors. CONCLUSION: Oral mucositis has a large associated painful component, in which the families of TRP, ET-1, TNF and ROS receptors and factors, among others, play a major role in its appearance. Knowledge of the pathogenesis of the pain in this pathology will allow pain therapies to be developed in future studies


Assuntos
Humanos , Estomatite/complicações , Odontalgia/fisiopatologia , Dor Facial/fisiopatologia , Dor Crônica/fisiopatologia , Neoplasias Bucais/complicações , Estomatite/fisiopatologia , Manejo da Dor/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia , Radioterapia/efeitos adversos
9.
Nat Med ; 27(1): 174-182, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33398159

RESUMO

Sustained pain is a major characteristic of clinical pain disorders, but it is difficult to assess in isolation from co-occurring cognitive and emotional features in patients. In this study, we developed a functional magnetic resonance imaging signature based on whole-brain functional connectivity that tracks experimentally induced tonic pain intensity and tested its sensitivity, specificity and generalizability to clinical pain across six studies (total n = 334). The signature displayed high sensitivity and specificity to tonic pain across three independent studies of orofacial tonic pain and aversive taste. It also predicted clinical pain severity and classified patients versus controls in two independent studies of clinical low back pain. Tonic and clinical pain showed similar network-level representations, particularly in somatomotor, frontoparietal and dorsal attention networks. These patterns were distinct from representations of experimental phasic pain. This study identified a brain biomarker for sustained pain with high potential for clinical translation.


Assuntos
Biomarcadores/análise , Neuroimagem Funcional/métodos , Medição da Dor/métodos , Adolescente , Adulto , Agentes Aversivos/toxicidade , Capsaicina/toxicidade , Conectoma/métodos , Conectoma/estatística & dados numéricos , Dor Facial/fisiopatologia , Feminino , Neuroimagem Funcional/estatística & dados numéricos , Humanos , Dor Lombar/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Modelos Neurológicos , Rede Nervosa/fisiopatologia , Dor/fisiopatologia , Medição da Dor/estatística & dados numéricos , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Paladar/efeitos dos fármacos , Paladar/fisiologia , Adulto Jovem
10.
Mol Neurobiol ; 58(6): 2836-2850, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33515176

RESUMO

Orofacial pain, including temporomandibular joint disorders pain, trigeminal neuralgia, dental pain, and debilitating headaches, affects millions of Americans each year with significant population health impact. Despite the existence of a large body of information on the subject, the molecular underpinnings of orofacial pain remain elusive. Two decades of research has identified that transient receptor potential (TRP) ion channels play a crucial role in pathological pain. A number of TRP ion channels are clearly expressed in the trigeminal sensory system and have critical functions in the transduction and pathogenesis of orofacial pain. Although there are many similarities, the orofacial sensory system shows some distinct peripheral and central pain processing and different sensitivities from the spinal sensory system. Relative to the extensive review on TRPs in spinally-mediated pain, the summary of TRPs in trigeminally-mediated pain has not been well-documented. This review focuses on the current experimental evidence involving TRP ion channels, particularly TRPV1, TRPA1, TRPV4, and TRPM8 in orofacial pain, and discusses their possible cellular and molecular mechanisms.


Assuntos
Dor Facial/metabolismo , Canais de Potencial de Receptor Transitório/metabolismo , Animais , Dor Facial/fisiopatologia , Humanos , Neuralgia/metabolismo , Neuralgia/fisiopatologia , Neuralgia do Trigêmeo/metabolismo , Neuralgia do Trigêmeo/fisiopatologia
11.
Clin Anat ; 34(1): 24-29, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32279338

RESUMO

BACKGROUND: The nociceptive receptive field of the vagus nerves in animals includes virtually the entire thoracic, abdominal and laryngopharyngeal regions. However, the role of the vagus nerves in the transmission of visceral pain in humans, with the exception of pain from coronary artery diseases, is believed to be insignificant. AIM: The purpose of this report is to map out the clinical visceral pain receptive field of the vagus nerves relative to its nociceptive counterpart in animals. MATERIALS AND METHODS: The PubMed database and PMC were searched for case reports of patients with orofacial pain believed by the author(s) of the article to be referred from underlying non-cardiac thoracic, laryngopharyngeal or abdominal diseases. Reports of diseases for which non-neural explanations for the orofacial spread of pain were suggested were excluded. RESULTS: A total of 52 case reports of jaw pain and/or otalgia referred from laryngopharyngeal and noncardiac thoracic sources were discovered. In addition, a multicenter prospective study found that 25.8% of more than 3,000 patients with thoracic aortic dissection experienced pain in the head and neck region. In stark contrast, no case reports of orofacially referred pain from abdominal diseases were found. DISCUSSION: The results indicate that the laryngopharyngeal and thoracic portions of the vagal receptive field are capable of referring pain orofacially while the abdominal portion is not. The roles of the somatotopic organization of the trigeminal sub nucleus caudalis and neuromodulation in this referral of pain were discussed. CONCLUSION: Referred orofacial pain can lead to delayed diagnosis and poorer outcome in visceral diseases.


Assuntos
Dor de Orelha/fisiopatologia , Dor Facial/fisiopatologia , Dor Referida/fisiopatologia , Nervo Vago/fisiopatologia , Dor Visceral/fisiopatologia , Humanos
12.
Vasc Endovascular Surg ; 55(1): 64-68, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32862800

RESUMO

First bite syndrome (FBS) is a sharp unilateral pain in the vicinity of the angle of the mandible after taking the first bite of a meal that presents typically after surgery in the area of the ipsilateral parapharyngeal space. It is not confirmed what the pathophysiology is that causes this pain, but the proposed mechanism is the iatrogenic damage of sympathetic fibers that extend from the superior cervical ganglion (SCG) to innervate the parotid gland. The presentation of this syndrome has been acknowledged in patients who have undergone head and neck tumor resections, but it has not been documented in the same thorough manner among vascular surgery cases in the parapharyngeal space, possibly because of a higher risk of development in other head and neck surgeries, or to under-reporting of cases. To date, only 5 cases of FBS status post carotid endarterectomy have been documented in the literature. Definitive treatment of FBS has not been established. Some studies have shown improvement with amitriptyline, and carbamazepine as well as botulinum toxin injections. We will present the case of a 75 year old male who developed first bite syndrome after a right carotid endarterectomy with efforts of raising awareness of a potential acute complication of carotid endarterectomy.


Assuntos
Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas/efeitos adversos , Dor Facial/etiologia , Mastigação , Glândula Parótida/inervação , Traumatismos dos Nervos Periféricos/etiologia , Gânglio Cervical Superior/lesões , Idoso , Analgésicos/uso terapêutico , Estenose das Carótidas/diagnóstico por imagem , Dor Facial/diagnóstico , Dor Facial/tratamento farmacológico , Dor Facial/fisiopatologia , Humanos , Masculino , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/tratamento farmacológico , Traumatismos dos Nervos Periféricos/fisiopatologia , Resultado do Tratamento
13.
J Manipulative Physiol Ther ; 43(8): 806-815, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32893024

RESUMO

OBJECTIVE: The purpose of this study was to assess the effects of 4-week protocol of diacutaneous fibrolysis (DF) compared with simulated DF (sham-DF) on myalgia and mouth opening. METHODS: In a sham randomized controlled trial, 34 women with temporomandibular disorders and myofascial pain were randomly divided as intervention group (IG) and sham-DF group (SG). The IG received 4 weeks of real DF, and the SG received sham. Pain was assessed through the visual analog scale and pressure pain thresholds (PPTs) on the temporomandibular joint (TMJ), and over the temporal and masseter muscles. The Mandibular Function Impairment Questionnaire was used to classify the participants regarding to the severity of the functional limitation related to TMD. RESULTS: Pain scores decreased for both groups, but the IG showed lower values at week 4, with between-group differences. Bilateral temporal PPT showed higher values at week 4, with between-group differences. The SG had lower PPTs but the IG had higher PPTs, both compared to baseline results. The time-by-group interaction and the frequency of participants above 40 mm of mouth opening showed a significant difference for the IG over time with higher results at the 4-week assessment compared to its own baseline. Both groups showed lower MFIQ scores from baseline to 4-week assessment. There was a lower frequency of a moderate level of severity for the IG. No differences were observed for TMJ or for the masseter muscles PPT. CONCLUSION: Improvements were observed for visual analog scale scores and PPTs on temporal muscles. There was a group-by-time interaction in the IG, suggesting a possible potential use of DF for mouth opening.


Assuntos
Dor Facial/terapia , Músculos da Mastigação/fisiopatologia , Mialgia/terapia , Síndromes da Dor Miofascial/terapia , Modalidades de Fisioterapia , Transtornos da Articulação Temporomandibular/terapia , Articulação Temporomandibular/fisiopatologia , Adulto , Dor Facial/patologia , Dor Facial/fisiopatologia , Feminino , Humanos , Mandíbula/patologia , Mandíbula/fisiopatologia , Massagem , Músculo Masseter/patologia , Músculo Masseter/fisiopatologia , Músculos da Mastigação/patologia , Boca , Mialgia/fisiopatologia , Síndromes da Dor Miofascial/fisiopatologia , Medição da Dor , Limiar da Dor , Índice de Gravidade de Doença , Músculo Temporal/patologia , Músculo Temporal/fisiopatologia , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Resultado do Tratamento , Adulto Jovem
14.
Neurosci Lett ; 736: 135287, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32763361

RESUMO

Within the reticular thalamic nucleus neurons express gamma aminobutyric acid (GABA) and these cells project to the ventral posteromedial thalamic nucleus. When GABA activity decreases the activity of excitatory cells in the ventral posteromedial nucleus would be expected to increase. In this study, we addressed the hypothesis that attenuating GABAergic cells in the reticular thalamic nucleus increases excitatory activity in the ventral posteromedial nucleus increasing varicella zoster virus (VZV) associated pain in the orofacial region. Adeno-associated virus (AAV) was infused in the reticular thalamic nucleus of Gad1-Cre rats. This virus transduced a G inhibitory designer receptor exclusively activated by designer drugs (DREADD) gene that was Cre dependent. A dose of estradiol that was previously shown to reduce VZV pain and increase GABAergic activity was administered to castrated and ovariectomized rats. Previous studies suggest that estradiol attenuates herpes zoster pain by increasing the activity of inhibitory neurons and decreasing the activity of excitatory cells within the lateral thalamic region. The ventral posteromedial nucleus was infused with AAV containing a GCaMP6f expression construct. A glass lens was implanted for miniscope imaging. Our results show that the activity of GABA cells within the reticular thalamic region decreased with clozapine N-oxide treatment concomitant with increased calcium activity of excitatory cells in the ventral posteromedial nucleus and an increased orofacial pain response. The results suggest that estradiol attenuates herpes zoster pain by increasing the activity of inhibitory neurons within the reticular thalamus that then inhibit excitatory activity in ventral posteromedial nucleus causing a reduction in orofacial pain.


Assuntos
Estradiol/farmacologia , Dor Facial/virologia , Glutamato Descarboxilase/metabolismo , Neuralgia/virologia , Tálamo/metabolismo , Animais , Dor Facial/metabolismo , Dor Facial/fisiopatologia , Feminino , Herpesvirus Humano 3 , Masculino , Neuralgia/metabolismo , Neuralgia/fisiopatologia , Ratos , Tálamo/efeitos dos fármacos , Tálamo/fisiopatologia
15.
Arq Neuropsiquiatr ; 78(6): 321-330, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32609188

RESUMO

BACKGROUND: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. OBJECTIVE: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. METHODS: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. RESULTS: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. CONCLUSIONS: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.


Assuntos
Transtornos da Articulação Temporomandibular , Neuralgia do Trigêmeo , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/fisiopatologia , Cefaleia , Humanos , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/diagnóstico , Neuralgia do Trigêmeo/diagnóstico
16.
Dev Med Child Neurol ; 62(11): 1294-1301, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32710570

RESUMO

AIM: To evaluate pain prevalence and characteristics in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) cerebral palsy (CP) motor types. METHOD: Seventy-five participants with a diagnosis of CP and confirmed dyskinetic or mixed (dyskinetic/spastic) motor type took part in a multisite cross-sectional study. The primary outcome was carer-reported pain prevalence (preceding 2wks) measured using the Health Utilities Index-3. Secondary outcomes were chronicity, intensity, body locations, quality of life, and activity impact. RESULTS: Mean participant age was 10 years 11 months (SD 4y 2mo, range 5-18y). There were 44 males and 31 females and 37 (49%) had predominant dyskinetic CP. Pain was prevalent in 85% and it was chronic in 77% of participants. Fifty-two per cent experienced moderate-to-high carer-reported pain intensity, which was significantly associated with predominant dyskinetic motor types (p=0.008). Pain occurred at multiple body locations (5 out of 21), with significantly increased numbers of locations at higher Gross Motor Function Classification System levels (p=0.02). Face, jaw, and temple pain was significantly associated with predominant dyskinetic motor types (p=0.005). Poorer carer proxy-reported quality of life was detected in those with chronic pain compared to those without (p=0.03); however, chronic pain did not affect quality of life for self-reporting participants. INTERPRETATION: Pain was highly prevalent in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types, highlighting a population in need of lifespan pain management. WHAT THIS PAPER ADDS: Chronic pain prevalence in children and adolescents with predominant dyskinetic and mixed (dyskinetic/spastic) motor types is high. Pain occurs across multiple body locations in predominant dyskinetic and mixed (dyskinetic/spastic) motor types. Less recognized locations of pain include the face, jaw, and temple for predominant dyskinetic motor types.


Assuntos
Paralisia Cerebral/fisiopatologia , Dor Crônica/fisiopatologia , Discinesias/fisiopatologia , Dor Facial/fisiopatologia , Dor Musculoesquelética/fisiopatologia , Adolescente , Paralisia Cerebral/complicações , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Estudos Transversais , Discinesias/epidemiologia , Discinesias/etiologia , Dor Facial/epidemiologia , Dor Facial/etiologia , Feminino , Humanos , Masculino , Espasticidade Muscular/complicações , Espasticidade Muscular/epidemiologia , Espasticidade Muscular/fisiopatologia , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/etiologia , Prevalência , Vitória/epidemiologia
17.
Eur Rev Med Pharmacol Sci ; 24(13): 7399-7411, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32706079

RESUMO

OBJECTIVE: The efficacy of melatonin as an analgesic agent has been well documented in animals and humans. However, the underlying mechanisms by which melatonin exerts antinociceptive effects on inflammatory pain are poorly understood. Here, we investigated the potential of melatonin to ameliorate inflammatory pain. MATERIALS AND METHODS: In vitro, ND7/23 neurons were treated with capsaicin. We used PCR and Western blot analyses to detect the expression of neuronal nitric oxide synthase (nNOS) in response to melatonin. Orofacial inflammatory pain was induced by 4% formalin administration on the right whisker pad of Sprague Dawley (SD) rats. The analgesic effect of melatonin was evaluated using mechanical threshold analyses. The expression level of nNOS in the trigeminal ganglion (TG) and trigeminal nucleus caudalis (Vc) neurons was assessed by RNAscope and immunohistochemistry. RESULTS: In vitro, capsaicin upregulated the expression of nNOS, which was dose-dependently reversed by melatonin pretreatment (p < 0.001). In a rat model of orofacial inflammatory pain, melatonin pretreatment significantly attenuated mechanical allodynia in both the acute and chronic phases (p < 0.05). Furthermore, melatonin decreased the formalin-evoked elevated nNOS mRNA and protein levels in the TG and Vc neurons in the acute and chronic phases (p < 0.05). CONCLUSIONS: Taken together, these results suggest that nNOS may play an active role in both peripheral and central processing of nociceptive information following orofacial inflammatory pain induction. The regulatory effect of melatonin on nNOS in inflammatory pain may have potential implications for the development of novel analgesic strategies.


Assuntos
Analgésicos/farmacologia , Dor Facial/prevenção & controle , Hiperalgesia/prevenção & controle , Melatonina/farmacologia , Óxido Nítrico Sintase Tipo I/metabolismo , Dor Nociceptiva/prevenção & controle , Limiar da Dor/efeitos dos fármacos , Células Receptoras Sensoriais/efeitos dos fármacos , Gânglio Trigeminal/efeitos dos fármacos , Núcleos do Trigêmeo/efeitos dos fármacos , Animais , Linhagem Celular , Modelos Animais de Doenças , Dor Facial/enzimologia , Dor Facial/fisiopatologia , Hiperalgesia/enzimologia , Hiperalgesia/fisiopatologia , Dor Nociceptiva/enzimologia , Dor Nociceptiva/fisiopatologia , Ratos Sprague-Dawley , Células Receptoras Sensoriais/enzimologia , Gânglio Trigeminal/metabolismo , Gânglio Trigeminal/fisiopatologia , Núcleos do Trigêmeo/enzimologia , Núcleos do Trigêmeo/fisiopatologia
18.
Vet Clin North Am Small Anim Pract ; 50(5): 1157-1181, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32680665

RESUMO

The corticolimbic system (prefrontal cortices, amygdala, and hippocampus) integrates emotion with cognition and produces a behavioral output that is flexible based on the environmental circumstances. It also modulates pain, being implicated in pathophysiology of maladaptive pain. Because of the anatomic and function overlap between corticolimbic circuitry for pain and emotion, the pathophysiology for maladaptive pain conditions is extremely complex. Addressing environmental needs and underlying triggers is more important than pharmacotherapy when dealing with feline orofacial pain syndrome or feline hyperesthesia syndrome. By contrast, autoimmune limbic encephalitis requires prompt diagnosis and management with immunosuppression and seizure control.


Assuntos
Doenças Autoimunes/veterinária , Doenças do Gato/fisiopatologia , Dor Facial/veterinária , Encefalite Límbica/veterinária , Animais , Doenças Autoimunes/fisiopatologia , Gatos , Córtex Cerebral/fisiologia , Dor Facial/fisiopatologia , Encefalite Límbica/fisiopatologia , Sistema Límbico/fisiologia , Exame Neurológico/veterinária
19.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e495-e501, jul. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-196502

RESUMO

BACKGROUND: Although magnetic resonance imaging (MRI) helps to clearly visualize the disorders in temporo-mandibular joint (TMJ), the relationship between cross-sectional and clinical findings has not been precisely established. The aim of this study was to evaluate the relationship between clinical symptoms and MRI findings in individuals with TMJ pain. MATERIAL AND METHODS: This cross-sectional study, conducted on the clinical and MRI findings of the patients, who applied to Uşak University, Oral and Maxillofacial Surgery Clinic with TMJ pain between the years 2016-2019. The primary predictor variables were MRI findings; disc position (normal, disc displacement with reduction (DDWR), disc displacement without reduction (DDWOR)), disc structural distortion (normal, folded, lengthened, round, biconvex, thick), condyle degeneration type (normal, moderate, severe) and joint effusion (JE) (absent, present). The primary outcome variable was pain, recorded on a visual analog scale (VAS) (numbered between 0-10). The other variables were demographic variables (age/gender). The relationship between clinical and MRI findings were statistically evaluated. The data were analysed by Kruskal Wallis and Mann Whitney U test. Chi-square (x2) test was used for categorical variable comparisons. P values < .05 were considered to indicate statistical significance. RESULTS: Clinical and MRI records of 700 TMJ, from 350 patients with the mean age of the 31 (12-65) were evaluated in this study. Statistically significant differences were found between; disc position and pain, disc position and JE; JE and pain; disc structural distortion and pain; and disc structural distortion and disc position. JE was seen more common in DDWOR group. The most common disc distortion, seen in patients with JE, is the folded type CONCLUSIONS: The present study can infer that pain is associated with disc position, JE, disc structural distortion, and DDWOR is associated with JE. Folded type disc is the most common disc type in TMJ with JE


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Dor Facial/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/fisiopatologia , Dor Facial/fisiopatologia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Estudos Transversais , Índice de Gravidade de Doença , Distribuição por Idade e Sexo , Medição da Dor , Estatísticas não Paramétricas
20.
J Headache Pain ; 21(1): 65, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503421

RESUMO

The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.


Assuntos
Dor Facial/patologia , Cefaleia/patologia , Gânglio Trigeminal/patologia , Nervo Trigêmeo/patologia , Animais , Tronco Encefálico/metabolismo , Tronco Encefálico/patologia , Tronco Encefálico/fisiopatologia , Dor Facial/metabolismo , Dor Facial/fisiopatologia , Cefaleia/metabolismo , Cefaleia/fisiopatologia , Humanos , Gânglio Trigeminal/metabolismo , Gânglio Trigeminal/fisiopatologia , Nervo Trigêmeo/metabolismo , Nervo Trigêmeo/fisiopatologia
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