%0 Journal Article %1 leonard_evidence_2009 %A Leonard, Guillaume %A Goffaux, Philippe %A Mathieu, David %A Blanchard, Jocelyn %A Kenny, Brendan %A Marchand, Serge %D 2009 %J Pain %K 80_and_over Adult Aged Cold_Temperature Female Humans Male Middle_Aged Neural_Inhibition Pain Pain_Measurement Pain_Threshold Physical_Stimulation Thermosensing Touch Trigeminal_Neuralgia %N 1-3 %P 217--223 %R 10.1016/j.pain.2009.09.009 %T Evidence of descending inhibition deficits in atypical but not classical trigeminal neuralgia %U http://www.ncbi.nlm.nih.gov/pubmed/19837512 %V 147 %X Trigeminal neuralgia (TN) is a rare neuropathic facial pain disorder. Two forms of TN, classical TN (CTN) and atypical TN (ATN), are reported and probably have different aetiologies. The aim of the present study was to evaluate the functional integrity of the diffuse noxious inhibitory controls (DNIC) in (1) a group of patients with classical trigeminal neuralgia (CTN), (2) a group of patients with atypical trigeminal neuralgia (ATN), and (3) a group of healthy controls in order to determine if a descending pain modulation deficit could participate in the pathophysiology of TN pain. DNIC responses of 14 CTN patients, 14 ATN patients and 14 healthy controls were obtained by comparing thermode-induced facial heat pain scores before and after activating DNIC. DNIC was triggered using a standard counter-irritation paradigm (i.e., immersion of the arm in painfully cold water). General sensitivity to pain was also evaluated by measuring mechanical pain thresholds over 18 points located outside the trigeminal territory. Healthy participants and CTN patients showed a 21\% and 16\% reduction in thermode-induced pain following the immersion, respectively (all p-values \textless.01), whereas ATN patients experienced no change (p=.57). ATN patients also had more tender points (mechanical pain thresholds\textless4.0kg) than CTN and healthy controls (all p-values \textless.05). Taken together, these results suggest that the underlying physiopathology differs between CTN and ATN and that a deficit in descending inhibition may further contribute to the pain experienced by patients with ATN.

@article{leonard_evidence_2009, abstract = {Trigeminal neuralgia {(TN)} is a rare neuropathic facial pain disorder. Two forms of {TN}, classical {TN} {(CTN)} and atypical {TN} {(ATN)}, are reported and probably have different aetiologies. The aim of the present study was to evaluate the functional integrity of the diffuse noxious inhibitory controls {(DNIC)} in (1) a group of patients with classical trigeminal neuralgia {(CTN)}, (2) a group of patients with atypical trigeminal neuralgia {(ATN)}, and (3) a group of healthy controls in order to determine if a descending pain modulation deficit could participate in the pathophysiology of {TN} pain. {DNIC} responses of 14 {CTN} patients, 14 {ATN} patients and 14 healthy controls were obtained by comparing thermode-induced facial heat pain scores before and after activating {DNIC.} {DNIC} was triggered using a standard counter-irritation paradigm (i.e., immersion of the arm in painfully cold water). General sensitivity to pain was also evaluated by measuring mechanical pain thresholds over 18 points located outside the trigeminal territory. Healthy participants and {CTN} patients showed a 21\% and 16\% reduction in thermode-induced pain following the immersion, respectively (all p-values {\textless}.01), whereas {ATN} patients experienced no change (p=.57). {ATN} patients also had more tender points (mechanical pain thresholds{\textless}4.0kg) than {CTN} and healthy controls (all p-values {\textless}.05). Taken together, these results suggest that the underlying physiopathology differs between {CTN} and {ATN} and that a deficit in descending inhibition may further contribute to the pain experienced by patients with {ATN.}}, added-at = {2011-08-03T20:31:37.000+0200}, author = {Leonard, Guillaume and Goffaux, Philippe and Mathieu, David and Blanchard, Jocelyn and Kenny, Brendan and Marchand, Serge}, biburl = {https://www.bibsonomy.org/bibtex/22b98e796c3da33239fd38fcb89ac5e80/crc_chus}, doi = {10.1016/j.pain.2009.09.009}, interhash = {60f878eab97981d3eca0a5e5b3873a17}, intrahash = {2b98e796c3da33239fd38fcb89ac5e80}, issn = {1872-6623}, journal = {Pain}, keywords = {80_and_over Adult Aged Cold_Temperature Female Humans Male Middle_Aged Neural_Inhibition Pain Pain_Measurement Pain_Threshold Physical_Stimulation Thermosensing Touch Trigeminal_Neuralgia}, month = dec, note = {{PMID:} 19837512}, number = {1-3}, pages = {217--223}, timestamp = {2011-08-03T20:35:33.000+0200}, title = {Evidence of descending inhibition deficits in atypical but not classical trigeminal neuralgia}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19837512}, volume = 147, year = 2009 }