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在健康人类中,三叉神经刺激对脑干兴奋性的调节作用大于对皮质兴奋性的调节作用。

Trigeminal nerve stimulation modulates brainstem more than cortical excitability in healthy humans.

作者信息

Mercante B, Pilurzi G, Ginatempo F, Manca A, Follesa P, Tolu E, Deriu F

机构信息

Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.

Neurological Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy.

出版信息

Exp Brain Res. 2015 Nov;233(11):3301-11. doi: 10.1007/s00221-015-4398-2. Epub 2015 Aug 11.

Abstract

Multiple sites in the central nervous system (CNS) have been hypothesized to explain the beneficial effects of transcutaneous trigeminal nerve stimulation (TNS) on several disorders. This work investigated the acute effects of TNS on the excitability of brainstem and intracortical circuits, as well as on sensorimotor integration processes at cortical level in physiological conditions. Brainstem excitability was evaluated in seventeen healthy subjects measuring the R1 and R2 areas of the blink reflex (BR) and its recovery cycle, with cortical excitability and sensorimotor integration assessed by probing short-interval (SICI) and long-interval (LICI) intracortical inhibition, with short-interval (SICF), intracortical facilitation (ICF), short-latency (SAI) and long-latency (LAI) inhibition measuring motor potentials evoked in the first dorsal interosseous muscle by TMS of the contralateral motor cortex. Neurophysiological parameters were assessed, in seventeen healthy subjects, before and after cyclic 20-min TNS delivered bilaterally to the infraorbital nerve. After TNS, the area of the R2 was significantly reduced (p = 0.018). By contrast, R1 area and R2 recovery cycle were unaffected. Similarly, SICI, ICF, LICI, SICF, SAI and LAI appeared unaltered after TNS. These data suggest that, in normal subjects, TNS mainly acts on brainstem polysynaptic circuits mediating the R2 component of the BR and plays a minor role in modifying the activity of higher-level structures involved in the R2 recovery cycle and in modulation of cortical excitability. A further investigation of a chronic TNS-induced effect may disclose a higher potential for TNS in producing measurable after effects on its CNS targets.

摘要

中枢神经系统(CNS)中的多个位点被认为可以解释经皮三叉神经刺激(TNS)对多种疾病的有益作用。这项研究调查了TNS在生理条件下对脑干和皮质内回路兴奋性以及皮质水平感觉运动整合过程的急性影响。在17名健康受试者中,通过测量眨眼反射(BR)的R1和R2区域及其恢复周期来评估脑干兴奋性,通过探测短间隔(SICI)和长间隔(LICI)皮质内抑制来评估皮质兴奋性和感觉运动整合,通过测量对侧运动皮质经颅磁刺激(TMS)在第一背侧骨间肌诱发的运动电位来评估短间隔(SICF)、皮质内易化(ICF)、短潜伏期(SAI)和长潜伏期(LAI)抑制。在17名健康受试者中,在双侧眶下神经进行20分钟周期性TNS前后评估神经生理参数。TNS后,R2区域显著减小(p = 0.018)。相比之下,R1区域和R2恢复周期未受影响。同样,TNS后SICI、ICF、LICI、SICF、SAI和LAI似乎未改变。这些数据表明,在正常受试者中,TNS主要作用于介导BR的R2成分的脑干多突触回路,在改变参与R2恢复周期的高级结构的活动和调节皮质兴奋性方面起次要作用。对慢性TNS诱导效应的进一步研究可能会揭示TNS对其CNS靶点产生可测量后效应的更大潜力。

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