Experimental evidence of a functional relationship within the brainstem trigeminocervical complex in humans
The existence of a trigeminocervical complex has been suggested based on animal data, but only indirect evidence exists in humans. We investigated the functional relationship between the trigeminal and the occipital region by stimulating one region and measuring electrical pain thresholds (EPTs) of...
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| Published in | Pain (Amsterdam) Vol. 163; no. 4; pp. 729 - 734 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wolters Kluwer
01.04.2022
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| Online Access | Get full text |
| ISSN | 0304-3959 1872-6623 1872-6623 |
| DOI | 10.1097/j.pain.0000000000002417 |
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| Abstract | The existence of a trigeminocervical complex has been suggested based on animal data, but only indirect evidence exists in humans. We investigated the functional relationship between the trigeminal and the occipital region by stimulating one region and measuring electrical pain thresholds (EPTs) of the corresponding opposite region. This study consists of 2 single-blinded, randomised protocols. Forty healthy participants were recruited in the propaedeutic protocol I. Electrical pain thresholds were measured on the V1 and the greater occipital nerve (GON) dermatome bilaterally as well as on the left forearm longitudinally before and after application of topical capsaicin. Protocol II was then online preregistered, and, additionally, the ipsilateral trigeminal dermatomes V2 and V3 were tested. Greater occipital nerve stimulation increased the EPT ipsilateral at V1 after 20 minutes ( P = 0.006) compared with baseline, whereas trigeminal stimulation increased the EPT at the ipsilateral ( P = 0.023) as well as the contralateral GON ( P = 0.001) after capsaicin application. Protocol II confirmed these results and additionally showed that GON stimulation with capsaicin increased EPTs ipsilateral at all 3 trigeminal dermatomes and that trigeminal stimulation on V1 led to an ipsilateral increase of EPTs at GON, V2, and V3. Our data suggest a strong functional interplay between the trigeminal and occipital system in humans. The fact that the stimulation of one of these dermatomes increases the EPT of the respective other nerve could be explained by segmental inhibition on the brainstem level. |
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| AbstractList | The existence of a trigeminocervical complex has been suggested based on animal data, but only indirect evidence exists in humans. We investigated the functional relationship between the trigeminal and the occipital region by stimulating one region and measuring electrical pain thresholds (EPTs) of the corresponding opposite region. This study consists of 2 single-blinded, randomised protocols. Forty healthy participants were recruited in the propaedeutic protocol I. Electrical pain thresholds were measured on the V1 and the greater occipital nerve (GON) dermatome bilaterally as well as on the left forearm longitudinally before and after application of topical capsaicin. Protocol II was then online preregistered, and, additionally, the ipsilateral trigeminal dermatomes V2 and V3 were tested. Greater occipital nerve stimulation increased the EPT ipsilateral at V1 after 20 minutes (P = 0.006) compared with baseline, whereas trigeminal stimulation increased the EPT at the ipsilateral (P = 0.023) as well as the contralateral GON (P = 0.001) after capsaicin application. Protocol II confirmed these results and additionally showed that GON stimulation with capsaicin increased EPTs ipsilateral at all 3 trigeminal dermatomes and that trigeminal stimulation on V1 led to an ipsilateral increase of EPTs at GON, V2, and V3. Our data suggest a strong functional interplay between the trigeminal and occipital system in humans. The fact that the stimulation of one of these dermatomes increases the EPT of the respective other nerve could be explained by segmental inhibition on the brainstem level.ABSTRACTThe existence of a trigeminocervical complex has been suggested based on animal data, but only indirect evidence exists in humans. We investigated the functional relationship between the trigeminal and the occipital region by stimulating one region and measuring electrical pain thresholds (EPTs) of the corresponding opposite region. This study consists of 2 single-blinded, randomised protocols. Forty healthy participants were recruited in the propaedeutic protocol I. Electrical pain thresholds were measured on the V1 and the greater occipital nerve (GON) dermatome bilaterally as well as on the left forearm longitudinally before and after application of topical capsaicin. Protocol II was then online preregistered, and, additionally, the ipsilateral trigeminal dermatomes V2 and V3 were tested. Greater occipital nerve stimulation increased the EPT ipsilateral at V1 after 20 minutes (P = 0.006) compared with baseline, whereas trigeminal stimulation increased the EPT at the ipsilateral (P = 0.023) as well as the contralateral GON (P = 0.001) after capsaicin application. Protocol II confirmed these results and additionally showed that GON stimulation with capsaicin increased EPTs ipsilateral at all 3 trigeminal dermatomes and that trigeminal stimulation on V1 led to an ipsilateral increase of EPTs at GON, V2, and V3. Our data suggest a strong functional interplay between the trigeminal and occipital system in humans. The fact that the stimulation of one of these dermatomes increases the EPT of the respective other nerve could be explained by segmental inhibition on the brainstem level. The existence of a trigeminocervical complex has been suggested based on animal data, but only indirect evidence exists in humans. We investigated the functional relationship between the trigeminal and the occipital region by stimulating one region and measuring electrical pain thresholds (EPTs) of the corresponding opposite region. This study consists of 2 single-blinded, randomised protocols. Forty healthy participants were recruited in the propaedeutic protocol I. Electrical pain thresholds were measured on the V1 and the greater occipital nerve (GON) dermatome bilaterally as well as on the left forearm longitudinally before and after application of topical capsaicin. Protocol II was then online preregistered, and, additionally, the ipsilateral trigeminal dermatomes V2 and V3 were tested. Greater occipital nerve stimulation increased the EPT ipsilateral at V1 after 20 minutes (P = 0.006) compared with baseline, whereas trigeminal stimulation increased the EPT at the ipsilateral (P = 0.023) as well as the contralateral GON (P = 0.001) after capsaicin application. Protocol II confirmed these results and additionally showed that GON stimulation with capsaicin increased EPTs ipsilateral at all 3 trigeminal dermatomes and that trigeminal stimulation on V1 led to an ipsilateral increase of EPTs at GON, V2, and V3. Our data suggest a strong functional interplay between the trigeminal and occipital system in humans. The fact that the stimulation of one of these dermatomes increases the EPT of the respective other nerve could be explained by segmental inhibition on the brainstem level. |
| Author | Nielsen, Trine May, Arne Jensen, Rigmor H. Gloss, Katrin Mehnert, Jan Asmussen, Katharina Basedau, Hauke |
| AuthorAffiliation | Department of Neurology, Rigshospitalet-Glostrup, Danish Headache Center, University of Copenhagen, Copenhagen, Denmark Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany |
| AuthorAffiliation_xml | – name: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – name: Department of Neurology, Rigshospitalet-Glostrup, Danish Headache Center, University of Copenhagen, Copenhagen, Denmark |
| Author_xml | – sequence: 1 givenname: Hauke surname: Basedau fullname: Basedau, Hauke organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – sequence: 2 givenname: Trine surname: Nielsen fullname: Nielsen, Trine organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – sequence: 3 givenname: Katharina surname: Asmussen fullname: Asmussen, Katharina organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – sequence: 4 givenname: Katrin surname: Gloss fullname: Gloss, Katrin organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – sequence: 5 givenname: Jan surname: Mehnert fullname: Mehnert, Jan organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany – sequence: 6 givenname: Rigmor H. surname: Jensen fullname: Jensen, Rigmor H. organization: Department of Neurology, Rigshospitalet-Glostrup, Danish Headache Center, University of Copenhagen, Copenhagen, Denmark – sequence: 7 givenname: Arne surname: May fullname: May, Arne organization: Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany |
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