Effects of chronic descending tractotomy on the response patterns of neurons in the trigeminal nuclei principalis and oralis

Differential effects of trigeminal tractotomy on Adelta- and C-fiber-mediated nociceptive responses

In this study we have tested in the rat, whether trigeminal tractotomy, which deprives the spinal trigeminal nucleus caudalis (Sp5C) of its trigeminal inputs, affected differentially nociceptive responses mediated by C- vs. Adelta-nociceptors from oral and perioral regions. Tractotomy had no effect on the threshold of the jaw opening reflex, induced by incisive pulp stimulation (Adelta-fiber-mediated), but blocked the formalin response (mainly C-fiber-mediated). These results suggest that nociceptive responses mediated by trigeminal C-fibers completely depend on the integrity of the Sp5C, while intraoral sensations triggered Adelta-fibers (especially of dental origin) are primarily processed in the rostral part of the spinal trigeminal nucleus.

Neurobiological and psychophysical mechanisms underlying the oral sensation produced by carbonated water

Carbonated drinks elicit a sensation that is highly sought after, yet the underlying neural mechanisms are ill-defined. We hypothesize that CO(2) is converted via carbonic anhydrase into carbonic acid, which excites lingual nociceptors that project to the trigeminal nuclei. We investigated this hypothesis using three methodological approaches. Electrophysiological methods were used to record responses of single units located in superficial laminae of the dorsomedial aspect of trigeminal subnucleus caudalis (Vc) evoked by lingual application of carbonated water in anesthetized rats. After pretreatment of the tongue with the carbonic anhydrase inhibitor dorzolamide, neuronal responses to carbonated water were significantly attenuated, followed by recovery. Using c-Fos immunohistochemistry, we investigated the distribution of brainstem neurons activated by intraoral carbonated water. Fos-like immunoreactivity (FLI) was significantly higher in the superficial laminae of dorsomedial and ventrolateral Vc in animals treated with carbonated water versus controls. Dorzolamide pretreatment significantly reduced FLI in dorsomedial Vc. We also examined the sensation elicited by carbonated water in human psychophysical studies. When one side of the tongue was pretreated with dorzolamide, followed by bilateral application of carbonated water, a significant majority of subjects chose the untreated side as having a stronger sensation and assigned significantly higher intensity ratings to that side. Dorzolamide did not reduce irritation elicited by pentanoic acid. The present data support the hypothesis that carbonated water excites lingual nociceptors via a carbonic anhydrase-dependent process, in turn exciting neurons in Vc that are presumably involved in signaling oral irritant sensations.

Ultrastructure of intracellularly labeled trigeminal vascular convergence neurons

Brainstem trigeminal vascular convergence (TVC) neurons receive an excitatory, nociceptive input from cranial blood vessels as well as the facial skin or cornea. In the present study, a population of cat TVC neurons was electrophysiologically identified and then intracellularly labelled with horseradish peroxidase. One TVC neuron from lamin IV and one from lamina V were processed for electron microscopy. Both cells have extensive axon terminal fields within trigeminal nucleus interpolaris as well as lamina IV and V of trigeminal nucleus caudalis. Analysis of thin sections showed that the soma and dendrites of the TVC neurons are contacted by synaptic terminals of various types. Both cells have myelinated axons and collaterals that give rise to unmyelinated preterminal processes. Within nucleus caudalis, terminals of the TVC cells contain round synaptic vesicles that synapse primarily with dendrites and spines.

Effects of tractotomy on nociceptive reactions induced by tooth pulp stimulation in the rat

The effects of a trigeminal tractotomy on nociceptive reactions induced by electrical stimulation of an inferior incisor were studied in freely moving rats. Behavioral tests were based on the observation of three reactions: jaw opening reflex, face scratching with forepaws, and head rotation toward the stimulated side. These reactions appear successively when the stimulation intensity increases. The results were evaluated by comparing a test group with a sham-operated group. Both groups were prepared surgically in the same way but only the former had undergone tractotomy. The results were as follows: The threshold of the jaw opening reflex triggered by stimulation of the tooth pulp ipsilateral to the tractotomy was not modified; however, the threshold of the face-scratching and the head rotation reactions rose (P less than or equal to 0.05) after tractotomy. These data suggest that the rostral part of the trigeminal sensory complex is involved in oral nociception. However, the modification of the face-scratching and head rotation thresholds reveals that the subnucleus caudalis also participates in this function when a certain level of pain is reached. The thresholds of the three nociceptive reactions evoked by stimulation of the contralateral tooth pulp were significantly lower in the test group than those in the sham-operated group (P less than or equal to 0.001), which is interpreted as being indicative of an modulating effect of the subnucleus caudalis on the contralateral trigeminal sensory complex. This effect was probably revealed by the use of a sham-operated group as a control.

Effect of trigeminal subnucleus caudalis cold block on the cerebrovascular-evoked responses of rostral trigeminal complex neurons

The technique of reversible cold block was used to explore the possibility that the trigeminal subnucleus caudalis (Vc) influences the responses of rostral trigeminal brainstem nuclear complex (TBNC) neurons to stimulation of the cerebrovasculature. Reversible cold block of Vc was found to abolish totally the responses of many rostral TBNC neurons to stimulation of the cerebrovasculature. The remaining neurons were not affected by the cold block. These data suggest that some rostral TBNC neurons may receive an indirect input from the cerebrovasculature via Vc while other rostral TBNC neurons receive a direct input from the cerebrovasculature.

The rostral part of the trigeminal sensory complex is involved in orofacial nociception

Single units responsive to noxious mechanical stimulation of orofacial receptive fields were recorded within the ventrobasal complex of the rat thalamus. The induced activities were compared before and after deafferentation of the subnucleus caudalis by a trigeminal tractotomy performed at the obex level. The receptive fields activated by noxious stimulation were classified as 'oral' when included in the oral, perioral or paranasal areas, and as 'facial' when included in facial regions distant from the oral cavity. After tractotomy, the unit responses to noxious stimulation of an oral field remained unchanged in 8 cases, decreased in 3 cases, and were suppressed in 4 cases. For units responding to noxious stimulation of a facial field, the responses were suppressed in 8 cases, decreased in two cases and remained unchanged in two other cases. So it appears that the rostral part of the trigeminal sensory complex (1) receives nociceptive afferents mainly from the oral and perioral areas and (2) is a relay in ascending pathways which convey painful sensations.

Common fur and mystacial vibrissae parallel sensory pathways: 14 C 2-deoxyglucose and WGA-HRP studies in the rat

Stimulation of mystacial vibrissae in rows A,B, and C increased (14C) 2-deoxyglucose (2DG) uptake in spinal trigeminal nucleus pars caudalis (Sp5c) mostly in ventral portions of laminae III-IV with less activation of II and V. Stimulation of common fur above the whiskers mainly activated lamina II, with less activation in deeper layers. The patterns of activation were compatible with an inverted head, onion skin Sp5c somatotopy. Wheatgerm Agglutinin-Horseradish Peroxidase (WGA-HRP) injections into common fur between mystacial vibrissae rows A-B and B-C led to anterograde transganglionic labeling only of Sp5c, mainly of lamina II with less label in layer V, and very sparse label in III and IV. WGA-HRP skin injections appear to primarily label small fibers, which along with larger fibers, were metabolically activated during common fur stimulation. Mystacial vibrissae stimulation increased 2DG uptake in ventral ipsilateral spinal trigeminal nuclei pars interpolaris (Sp5i) and oralis (Sp5o) and principal trigeminal sensory nucleus (Pr5). Common fur stimulation above the whiskers slightly increased 2DG uptake in ventral Sp5i, Sp5o, and possibly Pr5. The most dorsal aspect of the ventroposteromedial (VPM) nucleus of thalamus was activated contralateral to whisker stimulation. Stimulation of the common fur dorsal to the whiskers activated a region of dorsal VPM caudal to the VPM region activated during whisker stimulation. This is consistent with previous data showing that ventral whiskers and portions of the face are represented rostrally in VPM, and more dorsal whiskers and dorsal portions of the face are represented progressively more caudally in VPM. Mystacial vibrissae stimulation activated the contralateral primary sensory SI barrelfield cortex and a separate region in the second somatosensory SII cortex. Common fur stimulation above the whiskers activated a cortical region between the SI and SII whisker activated regions of cortex. It is proposed that this region represented the combined SI and SII common fur regions of somatosensory neocortex. Both whisker and common fur stimulation activated all layers of cortex, with layer IV being most activated followed by II-III, V, and VI. These data indicate that sensory input from the mystacial vibrissae in the adult rat is processed in brainstem, thalamic, and cortical pathways which are predominantly parallel to those which process information from the neighboring common fur sensory receptors.(ABSTRACT TRUNCATED AT 400 WORDS)

The neurobiology of facial and dental pain: present knowledge, future directions

This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp.

Neuronal responses in rostral trigeminal brain-stem nuclei of macaque monkeys after chronic trigeminal tractotomy

Unilateral trigeminal tractotomy was carried out at the level of the obex, just rostral to the subnucleus caudalis, in five young adult Macaca fascicularis monkeys. The animals had been trained previously to perform a behavioral shock avoidance task in response to electrical stimulation of dental pulp and facial skin. Tractotomy produced an elevation in the stimulus strength which elicited escape behavior when facial skin was stimulated but not when the tooth pulp was stimulated. Unit activity, evoked by electrical stimulation of the tooth pulp and facial skin as well as innocuous and noxious mechanical stimulation of orofacial regions, was recorded from neurons in the trigeminal main sensory nucleus and the subnuclei oralis and interpolaris of the spinal nucleus 8 to 12 weeks after tractotomy. Primary afferent input to these nuclei is unaffected by the tractotomy which is located more caudally. The tractotomy interrupts primary afferent input into the trigeminal nucleus caudalis and also intranuclear connections between caudalis and the more rostral nuclei. Forty-one units contralateral and 47 ipsilateral to the tractotomy were studied. Thirty-six of the units responded only to low-threshold mechanical or electrical stimulation of orofacial zones, 46 were responsive to innocuous mechanical and electrical stimulation of orofacial zones and also to electrical stimulation of the dental pulp. Six units responded only to dental pulp stimulation. No statistically significant differences between the populations of neurons ipsilateral and contralateral to the tractotomies were found relating to the size or location of the peripheral receptive fields, latencies, thresholds, mean firing densities, or responsiveness to the various forms of stimulation. The behavioral results suggest that trigeminal relay neurons rostral to the obex are able to signal dental pain sensation, and the physiological studies confirm that the firing of such neurons is unaffected by tractotomy. The physiological studies demonstrate that the firing patterns of relay neurons activated by natural and electrical cutaneous facial stimuli and which are located in trigeminal brain-stem nuclei rostral to the obex are also not affected by tractotomy. The cutaneous facial analgesia observed after tractotomy thus appears to be due to deafferentation of relay neurons in trigeminal nucleus caudalis rather than to alterations in coding patterns in rostrally located trigeminal neurons due to interruption of the intratrigeminal pathway between the caudal and rostral nuclear groups.

Cell size analysis of trigeminal primary afferent neurons comprizing individual peripheral branches of the rat mandibular nerve

Cell bodies of primary afferent neurons comprizing individual peripheral branches of the rat mandibular nerve were labeled by retrograde transport of HRP and their sizes were measured. Approximately 60% of cell bodies of primary neurons innervating the intra and perioral structures through the inferior alveolar, lingual, mental, and buccal nerves were in the range between 300 and 600 micron 2 in cross-sectional area: mean +/- SD 509 +/- 243 micron 2, 420 +/- 181 micron 2, 469 +/- 200 micron 2, and 444 +/- 186 micron 2, respectively. Sixty-five percent of cell bodies of primary neurons innervating the periphery of the face through the cutaneous branch of the mylohyoid and auriculotemporal nerves were smaller than 300 micron 2 in cross-sectional area: 285 +/- 170 micron 2 and 286 +/- 172 micron 2, respectively. The data suggest that the intraoral/perioral region is different from the skin in the peripheral region of the face in terms of the mechanism by which sensory information is transmitted to the central nervous system. This difference may explain some of the formerly enigmatic phenomena such as the differential effects of spinal trigeminal tractotomy.

Observations on facial nociception in a monkey after destruction of the rostral part of the trigeminal sensory nuclear complex

Facial sensibility was assessed in a cynomolgus monkey in whom the trigeminal main sensory nucleus and the rostral part of the trigeminal nucleus oralis on one side had been destroyed. The animal responded equally to noxious mechanical stimuli applied to the two sides of the face; no deficiency in nociception could be detected. This finding suggests that the synaptic connections made by nociceptor afferents from the face in rostral parts of the trigeminal sensory nuclear complex are not essential for facial nociception. These observations are also consistent with the opinion that, from a functional point of view, facial nociceptor afferents have their principal synaptic connections in the nucleus caudalis of the trigeminal spinal complex.

Pathways for orofacial pain sensation in the trigeminal brain-stem nuclear complex of the Macaque monkey

Eleven Macaque monkeys underwent a variety of lesions in the trigeminal afferent system; namely, tractotomy, rhizotomy, and radiofrequency destruction of various components of the bulbospinal trigeminal nuclear complex. Behavioral responses were evaluated before and after the lesions using a quantitative paradigm which measured lever-pressing in response to electrical stimulation of the dental pulp or facial skin, and by assessing adversive responses to facial cutaneous and intraoral pin-scratch. Thresholds for lever-pressing in response to cutaneous facial stimulation were elevated by tractotomy, elevated further by a combination of tractotomy and rhizotomy of the seventh, ninth, and 10th cranial nerves and cervical dorsal roots C1-3, and maximally elevated by complete radiofrequency destruction of the trigeminal nucleus caudalis. These lesions also abolished adversive responses to cutaneous facial pin-scratch. None of these lesion combinations, however, altered lever-pressing responses to dental pulp stimulation. Radiofrequency destruction of the trigeminal nuclei principalis, oralis, and interpolaris caused elevations of lever-pressing thresholds in response to dental pulp stimulation, and also smaller but statistically significant elevations on cutaneous electrical stimulation. Mild reductions in adversive responses to cutaneous pin-scratch were also produced by these rostral nuclear lesions, suggesting analgesia. The experiments suggest that primary afferent fibers for dental pain perception travel only in the trigeminal nerve and that these fibers relay via the trigeminal brain-stem nuclei principalis, oralis, and interpolaris. Primary afferent fibers for cutaneous facial pain perception travel in the trigeminal, facial, glossopharyngeal, and vagus nerves, and the upper cervical dorsal and ventral roots, and these afferents relay mainly in the trigeminal nucleus caudalis.

Ascending and descending internuclear connections of the trigeminal sensory nuclei in the cat. A study with the retrograde and anterograde horseradish peroxidase technique

The distribution of cells of origin of ascending and descending internuclear connections in the trigeminal sensory nuclei was studied by the retrograde horseradish peroxidase technique in the cat. The termination of collaterals of these ascending axons was also studied by the anterograde transport of horseradish peroxidase. Following injections of horseradish peroxidase into the ventral part of the principal sensory nucleus and the adjacent reticular formation many small neurons were labeled ipsilaterally in the whole area of the caudal portion of the nucleus interpolaris and in laminae III and IV of the nucleus caudalis. Labeled neurons were also found in laminae I and V. Injections limited to either nucleus oralis, the ventral part of the principal sensory nucleus and the medial parabrachial nucleus labeled similar types of neurons in the above regions with a topographic relationship; neurons in the dorsal part of the nuclei caudalis and interpolaris project, dorsally, to rostral portions of the trigeminal sensory nuclei while those in the ventral part of the nuclei caudalis and interpolaris project ventrally. Anterograde labeling of axons arising from the nucleus caudalis demonstrates that the axons ascend in the intranuclear bundles and the adjacent reticular formation, and give off collaterals to the nuclei interpolaris and oralis, and the ventral part of the principal sensory nucleus. Injections limited to the nucleus caudalis labeled small neurons in the rostral portion of the nucleus oralis and the caudal portion of the nucleus interpolaris. The present study suggests that these ascending and descending internuclear connections of the trigeminal sensory nuclei may modulate transmission of afferent inputs to various projection sites, such as thalamus, superior colliculus, cerebellum and spinal cord.

Effect of trigeminal tractotomy on dental sensation in humans

Two patients with intractable pain of the head and neck due to cancer underwent trigeminal tractotomy and rhizotomy of the ninth and 10th cranial nerves, as well as an upper cervical dorsal rhizotomy. Postoperatively, cutaneous analgesia ws present ipsilaterally in peripheral portions of the face and the neck, but paramedian facial regions and the oral mucosa were hypalgesic. The procedures had no significant effect on dental pain perception in these patients, as tested electrically and thermally. These results are similar to those in recent reports of dental sensation after trigeminal tractotomy in animals. The results raise questions about the validity of the commonly espoused hypothesis that trigeminal nucleus caudalis is the exclusive locus for processing of orofacial nociceptive information. The findings are consistent with the idea that the entire spinal trigeminal nucleus serves as a site for integration of pain-related information from orofacial structures that are supplied by afferent fibers in the fifth, seventh, ninth, and 10th cranial nerves and the upper cervical nerve roots.

Effect of trigeminal tractotomy on behavioral response to dental pulp stimulation in the monkey

Trigeminal tractotomy near the level of the obex was carried out in 10 macaque monkeys. Behavioral responses were evaluated by a quantitative paradigm measuring lever-press responses to electrical stimulation of the dental pulp or facial skin, and by assessing facial response to cutaneous pin-scratch before and after the tractotomy. Two pharmacological agents, strychnine and L-dopa, were administered and their effect on behavioral responses to these stimuli was studied. Tractotomy did not produce dental analgesia. Thresholds for escape from cutaneous electrical stimulation of facial skin, however, were elevated, consistent with marked hypalgesia to pin-scratch. The adversive responses to pin-scratch were absent in peripheral portions of the face, but near the midline and inside the oral cavity they were usually decreased or normal. Pharmacological agents caused a reduction in escape thresholds to cutaneous electrical stimulation and a shrinkage or abolition of the zone of analgesia to pin-scratch. The results imply that trigeminal nucleus caudalis, which undergoes deafferentation by tractotomy, may not be essential for processing of nociceptive information from the teeth, oral cavity, and midline facial zones. This findings is contrary to long-held hypotheses concerning facial pain mechanisms. The ability of strychnine and L-dopa to alter nociceptive escape thresholds is consistent with the idea, suggested by Denny-Brown, that facial nociception depends on central summation in the entire spinal trigeminal nucleus from overlapping afferent inputs contained in the trigeminal nerve, other cranial nerves, and the upper cervical nerve roots.

Tooth pulp input to the spinal trigeminal nucleus: a comparison of inhibitions following segmental and raphe magnus stimulation

In rats and cats anaesthetized with urethane a comparison was made of the inhibitory effects of raphe magnus (NRM) and segmental (facial skin) stimulation on neurones in nucleus caudalis excited by tooth pulp stimulation. The upper and lower ipsilateral incisor teeth were used in rats (176 neurones) and the corresponding canine teeth in cats (34 neurones). The recording sites were located in all layers of nucleus caudalis and in the underlying reticular formation. Both the evoked responses and the conditioning effects were similar in the two species. Both forms of conditioning inhibited about half the neurones tested but only as small proportion was influenced from both sources. NRM stimulation had almost identical effects on neurones driven from upper teeth or from lower teeth and tended to act on those cells with longer latencies. Segmental stimulation influenced the majority of shorter latency cells and produced greater inhibitions of upper tooth pulp neurones. Diffuse noxious inhibitory controls were also observed for certain neurones.

Development of the brain stem in the rat. IV. Thymidine-radiographic study of the time of origin of neurons in the pontine region

Groups of pregnant rats were injected with two successive daily doses of 3H-thymidine from gestational day 12 and 13 (E12 + 13) until the day before parturition (E21 + 22) in order to label in their embryos the proliferating precursors of neurons. At 60 days of age the proportion of neurons generated (or no longer labeled) on specific embryonic days was determined quantitatively in 14 nuclei of the pontine region. Peak production time of neurons of the trigeminal mesencephalic nucleus was on day E11 or earlier, with a small proportion generated on day E12. Peak production time of the trigeminal motor neurons was on day E12, with a small proportion produced earlier. Neurons of the principal sensory nucleus were generated between days E13 and E16, with a peak on day E14; the late-produced neurons tended to belong to a class of intermediate and large cells. The bulk of the neurons of the supratrigeminal and infratrigeminal nuclei arose on days E15 and E16. Neurons of the locus coeruleus are produced mostly on day E12, with about 20% of the cells arising on day E13. The bulk of the neurons of the dorsal tegmental nucleus (Gudden's) are produced between days E13 and E15, whereas most of the neurons of the deep (ventral) tegmental nucleus are produced on day E15. A dorsal-to-caudal gradient was also obtained between the dorsal and ventral nuclei of the lateral lemniscus, the neurons of the former being generated between days E12 and E15; the latter, between days E13 and E17. The neurons of both the pars lateralis and the pars medialis of the parabrachial nucleus were produced simultaneously between days E13 and E15, with a peak on day E13. The heterogeneous collection of neurons of the pontine paramedial reticular formation was produced for day E11 (or earlier) until day E15. Finally, the neurons of the raphe pontis parvicellularis were generated at an even rate between days E13 and E15, whereas the bulk of the neurons of the raphe pontis magnocellularis were produced on days E15 and E16. On the basis of datings obtained for 9 subdivisions of the entire brain stem trigeminal complex, hypotheses were offered of the cytogenetic components of the system. The sequence of neuron production in the dorsal and deep tegmental nuclei was related to their connections with divisions of the mammillary and habenular nuclei on a "first come-first serve" basis.

Diffuse noxious inhibitory controls (DNIC). Effects on trigeminal nucleus caudalis neurones in the rat

We have extended our previous description at the dorsal horn level of Diffuse Noxious Inhibitory Controls (DNIC) to the trigeminal nucleus caudalis of the intact anaesthetized rat. These controls produce powerful long-lasting inhibitions of all activities of convergent neurones and can be elicited by noxious stimuli applied to widespread areas of the body unrelated to the receptive fields of the neurones under study. In nucleus caudalis, 39/40 convergent neurones were found to be under DNIC produced from the tail, paws, viscerae, nose and ears. DNIC was only elicited by noxious stimuli which included pinch, noxious heat and intraperitoneal bradykinin. DNIC strongly inhibited both the A fibre and C fibre related activities of trigeminal convergent neurones whether evoked electrically or naturally with the degree of inhibition ranging between 55 and 100% in the most cases. Of 43 non-convergent neurones, noxious only, innocuous, proprioceptive and cold responsive, 42 were unaffected by DNIC. The results demonstrate that both the neuronal responses and DNIC at the trigeminal nucleus caudalis level in the rat are similar to those reported for the dorsal horn.