Chung Moonyoung, Huh Ryoong
Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhayng University College of Medicine, Bucheon, Korea.
Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
J Korean Neurosurg Soc. 2022 Sep;65(5):640-651. doi: 10.3340/jkns.2022.0004. Epub 2022 May 16.
Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.
针对三叉神经痛的神经调节干预的临床研究尚未显示出有前景的结果。这可能是由于慢性三叉神经病变的病理生理学尚未被完全理解。慢性三叉神经病变包括三叉神经自主性病变、疼痛性三叉神经病变和持续性特发性面部疼痛。这种疾病是由疼痛处理系统中的复杂异常引起的，该系统由情感、情绪和感觉成分组成，而不仅仅是异常感觉。因此，对疼痛系统的综合理解对于慢性三叉神经病变的适当神经调节是必要的。参与复杂疼痛处理的可能神经调节靶点如下：腹后内侧核、导水管周围灰质、运动皮层、伏隔核、丘脑底核、苍白球内侧部、前扣带回皮层、下丘脑、蝶腭神经节和枕神经。总之，三叉神经痛的神经调节干预尚待阐明；该领域需要未来的进展。
