Li Yuzhou, Yang Guangju, Zhai Xinli, Kang Yanfeng, Xie Qiu-Fei
Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
Chongqing Medical University School of Stomatology, Chongqing, 401147, China.
Odontology. 2023 Jan;111(1):217-227. doi: 10.1007/s10266-022-00737-1. Epub 2022 Sep 12.
This study aimed to evaluate somatosensory function in Chinese patients with trigeminal neuralgia (TN) using a standard quantitative sensory testing (QST) battery and electrophysiological tests consisting of contact heat-evoked potentials (CHEPs) and blink reflex (BR). Twenty patients with TN and 20 sex- and age-matched healthy controls were recruited for this study. A standard QST protocol recommended by the German Research Network on Neuropathic Pain was carried out on the patients' painful and contralateral faces, the controls' right faces, and all participants' right hands. The CHEPs and BR were recorded at the Cz electrode and bilateral lower bellies of the orbicularis oculi, respectively, with thermal stimuli applied to both sides of the patient's face and the control's right face. The cold detection threshold, heat pain threshold, and mechanical pain threshold on the painful face were lower than those of healthy controls (P < 0.05), whereas the cold pain threshold and mechanical detection threshold were higher (P < 0.05) on the painful faces than those of the contralateral faces from patients or healthy controls. Mechanical pain sensitivity was higher in both test sites than in healthy controls (P < 0.05). Significantly longer N latencies (P < 0.05) and lower N-P amplitudes (P < 0.01) were detected in the patients' painful sites than in the contralateral sites and those of healthy controls. Comprehensive somatosensory abnormalities were found in painful facial sites in patients with TN, suggesting disturbances in the processing of somatosensory stimuli. Deficiencies in electrophysiological tests further revealed unilaterally impaired function of the trigeminal pathway in TN patients.
本研究旨在通过标准定量感觉测试(QST)组合以及包括接触热诱发电位(CHEP)和眨眼反射(BR)的电生理测试,评估中国三叉神经痛(TN)患者的躯体感觉功能。本研究招募了20例TN患者以及20例年龄和性别匹配的健康对照者。对患者的患侧和对侧面部、对照者的右侧面部以及所有参与者的右手,执行了德国神经性疼痛研究网络推荐的标准QST方案。分别在Cz电极和双侧眼轮匝肌下腹部记录CHEP和BR,热刺激施加于患者面部两侧和对照者右侧面部。患侧面部的冷觉检测阈值、热痛阈值和机械痛阈值低于健康对照者(P < 0.05),而患侧面部的冷痛阈值和机械检测阈值高于患者或健康对照者的对侧面部(P < 0.05)。两个测试部位的机械痛敏感性均高于健康对照者(P < 0.05)。与对侧部位和健康对照者相比,患者患侧部位检测到N潜伏期明显更长(P < 0.05)且N - P波幅更低(P < 0.01)。在TN患者的患侧面部发现了全面的躯体感觉异常,提示躯体感觉刺激处理存在紊乱。电生理测试的缺陷进一步揭示了TN患者三叉神经通路单侧功能受损。