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强光激活三叉神经伤害性通路。

Bright light activates a trigeminal nociceptive pathway.

机构信息

Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, 18-214 Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA.

出版信息

Pain. 2010 May;149(2):235-242. doi: 10.1016/j.pain.2010.02.004. Epub 2010 Mar 4.

Abstract

Bright light can cause ocular discomfort and/or pain; however, the mechanism linking luminance to trigeminal nerve activity is not known. In this study we identify a novel reflex circuit necessary for bright light to excite nociceptive neurons in superficial laminae of trigeminal subnucleus caudalis (Vc/C1). Vc/C1 neurons encoded light intensity and displayed a long delay (>10s) for activation. Microinjection of lidocaine into the eye or trigeminal root ganglion (TRG) inhibited light responses completely, whereas topical application onto the ocular surface had no effect. These findings indicated that light-evoked Vc/C1 activity was mediated by an intraocular mechanism and transmission through the TRG. Disrupting local vasomotor activity by intraocular microinjection of the vasoconstrictive agents, norepinephrine or phenylephrine, blocked light-evoked neural activity, whereas ocular surface or intra-TRG microinjection of norepinephrine had no effect. Pupillary muscle activity did not contribute since light-evoked responses were not altered by atropine. Microinjection of lidocaine into the superior salivatory nucleus diminished light-evoked Vc/C1 activity and lacrimation suggesting that increased parasympathetic outflow was critical for light-evoked responses. The reflex circuit also required input through accessory visual pathways since both Vc/C1 activity and lacrimation were prevented by local blockade of the olivary pretectal nucleus. These findings support the hypothesis that bright light activates trigeminal nerve activity through an intraocular mechanism driven by a luminance-responsive circuit and increased parasympathetic outflow to the eye.

摘要

强光可引起眼部不适和/或疼痛;然而,将亮度与三叉神经活动联系起来的机制尚不清楚。在这项研究中,我们确定了一个新的反射回路,该回路对于强光刺激三叉神经尾核(Vc/C1)浅层的伤害性神经元是必需的。Vc/C1 神经元编码光强度,并显示出长延迟(>10s)的激活。将利多卡因注射到眼睛或三叉神经根(TRG)中完全抑制了光反应,而局部应用于眼部表面则没有效果。这些发现表明,光诱发的 Vc/C1 活性是由眼内机制介导的,并通过 TRG 传递。通过眼内注射血管收缩剂去甲肾上腺素或苯肾上腺素破坏局部血管运动活性,阻断光诱发的神经活性,而眼部表面或眼内 TRG 注射去甲肾上腺素则没有效果。瞳孔肌肉活动没有贡献,因为阿托品不会改变光诱发的反应。将利多卡因注射到上涎核中可减弱光诱发的 Vc/C1 活性和流泪反应,表明增加副交感神经传出对于光诱发的反应至关重要。该反射回路还需要通过辅助视觉通路的输入,因为橄榄前脑桥核的局部阻断可防止 Vc/C1 活性和流泪反应。这些发现支持了这样一种假设,即强光通过由亮度反应回路驱动的眼内机制激活三叉神经活动,并增加副交感神经传出到眼睛。

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