A new trigemino-nociceptive stimulation model for event-related fMRI
A Stankewitz, HL Voit,
U Bingel,
C Peschke, A May,
HL Voit
Department of Radiology, University Medical Centre Erlangen, Nuremberg, Germany
Search for more papers by this authorU Bingel
Department of Neurology, University Medical Centre Hamburg Eppendorf, Hamburg, and
Search for more papers by this authorCorresponding Author
A May
Department of Systems Neuroscience and
Dr Arne May MD, Assistant Professor of Neurology, Department of Systems Neuroscience, University of Hamburg Eppendorf (UKE), Martinistrasse 52, D-20246 Hamburg, Germany. Tel. + 49 (0) 407 4105 9189, fax + 49 (0) 407 4105 9955, e-mail [email protected]Search for more papers by this authorA Stankewitz, HL Voit,
U Bingel,
C Peschke, A May,
HL Voit
Department of Radiology, University Medical Centre Erlangen, Nuremberg, Germany
Search for more papers by this authorU Bingel
Department of Neurology, University Medical Centre Hamburg Eppendorf, Hamburg, and
Search for more papers by this authorCorresponding Author
A May
Department of Systems Neuroscience and
Dr Arne May MD, Assistant Professor of Neurology, Department of Systems Neuroscience, University of Hamburg Eppendorf (UKE), Martinistrasse 52, D-20246 Hamburg, Germany. Tel. + 49 (0) 407 4105 9189, fax + 49 (0) 407 4105 9955, e-mail [email protected]Search for more papers by this authorAbstract
Functional imaging of human trigemino-nociceptive processing provides meaningful insights into altered pain processing in head and face pain diseases. Although functional magnetic resonance imaging (fMRI) offers high temporal and spatial resolution, most studies available were done with radioligand-positron emission tomography, as fMRI requires non-magnetic stimulus equipment and fast on–off conditions. We developed a new approach for painful stimulation of the trigeminal nerve that can be implemented within an event-related design using fMRI and aimed to detect increased blood-oxygen-level-dependent (BOLD) signals as surrogate markers of trigeminal pain processing. Using an olfactometer, 20 healthy volunteers received intranasally standardized trigeminal nociceptive stimuli (ammonia gas) as well as olfactory (rose odour) and odourless control stimuli (air puffs). Imaging revealed robust BOLD responses to the trigeminal nociceptive stimulation in cortical and subcortical brain areas known to be involved in pain processing. Focusing on the trigeminal pain pathway, significant activations were observed bilaterally in brainstem areas at the trigeminal nerve entry zone, which are agreeable with the principal trigeminal nuclei. Furthermore, increased signal changes could be detected ipsilaterally at anatomical localization of the trigeminal ganglion and bilaterally in the rostral medulla, which probably represents the spinal trigeminal nuclei. However, brainstem areas involved in the endogenous pain control system that are close to this anatomical localization, such as raphe nuclei, have to be discussed. Our findings suggest that mapping trigeminal pain processing using fMRI with this non-invasive experimental design is feasible and capable of evoking specific activations in the trigeminal nociceptive system. This method will provide an ideal opportunity to study the trigeminal pain system in both health and pathological conditions such as idiopathic headache disorders.
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